CAFAF Annual Conference Registration

Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
I require Continuing Education Credits with National Association of Social Workers.

YesNo
I Acknowledge in order to receive credits:
- I will listen to room monitors, and make sure I sign in and sign out with the following information:
  - My name as I want it to appear on my approved credits.
  - The time when I signed in.
  - The time that the class/workshop ended.
  - The number of hours requested for that class/workshop.
  - If I have questions, I will see the CAFAF staff at the Registration Table.
I am a*

Workshop FacilitatorDCF Licensed foster, Adoptive, Relative Care Parent or Special StudyDCF Staff MemberPrivate Agency Licensed foster, Adoptive, Relative Care Parent or Special StudyPrivate Agency Staff MemberCAFAF Staff, Board MemberFoster Parent Award WinnerSocial Worker Award WinnerCommunity Partner Award WinnerKnowledge Seeking Private Citizen
My Social Worker is:
My Social Worker is located at DCF in:

BridgeportDanburyHartfordManchesterMeridenMiddletownMilfordNew BritianNew HavenNorwalkNorwichTorringtonWaterburyWillimantic
I will attend*

FridaySaturdayBoth Friday and Saturday
Friday Lunch:*

I will attendI will not attend
Saturday Lunch:*

I will attendI will not attend
I would like to take the Hybrid CPR Course:

YesNo
Hybrid CPR Course Selection:

Friday, English (Workshop A)Friday, Spanish (Workshop B)Saturday, English (Workshop A)Saturday, Spanish (Workshop B)
I understand that by clicking this box to select a Hybrid CPR Course I will pay the sum of $45 by cash or check to the trainer upon entering the workshop.
Should be Empty: