Conference Registration and Fees
(Does not include the cost of hotel or travel):

Register before March 8 for the best prices!

Need to renew your CSLN membership?

You can now renew your membership along with your conference registration. You will see the information and pricing on the Payment page after completing this form.

* indicates required fields

Your Name: *

Organization:

Position or Title:

Services your organization provides (check all that apply):
ILS   SLS   Supported Employment   RC funded Day Service
Other:

Email: *

Address 1: *

Address 2:

City: *

State: * Zip Code: *

Daytime Phone: *

Your Registration Type (select one) CSLN Member, Self-Advocate or Family Member - $180.00 Non-CSLN Member, Self-Advocate or Family - $205.00 CSLN Member, Staff Member/Professional - $265.00 Non-CSLN Member, Staff Member/Professional - $290.00  *

Additional Attendees

Register additional people here.

* Only for the people you are registering

Self-Advocate or Family Member:
(Members $180, Non-Members $205)

Staff Member/Professional with Agency:
(Members $265, Non-Members $290)

SPECIAL ACCOMMODATIONS:
For each item you check, indicate how many, and which of your attendees needs each

Please Choose All That Apply
Sign Language Interpreting Services
Accommodations for Conference Materials
Vegetarian Meals
Specially Prepared Food (add details below)
Other (add details below)
Notes: (* Required if you checked any of the boxes above)

Cancellation/Refund Policy

• Cancellations must be received in writing
• All cancellations will be subject to a 50% administration fee
• Cancellations after March 19, 2010 cannot be refunded (including "no-shows")
• No refunds will be given on-site
• Substitutions are welcome with advance notice
• Mail Cancellations to: CSLN at 5945 Palm Drive, Carmichael, CA 95608

I agree to the above Cancellation/Refund Policy *

Submit your information with the button below. For payment you can use our PayPal buttons, or mail a check to the address below.