To register, please complete this form including payment information. Each
attendee must complete a separate form. The conference registration fee covers conference workshops,
plenary sessions, refreshment breaks and breakfasts. Pre-conference events are listed separately
and not included in the general registration fee.
Please note: The
National Association of Peer Specialists is NOT responsible for lodging, transportation or other costs. Participants are responsible
for making their own arrangements including those costs.
Name
Telephone #
Street Address or P.O. Box
City
______________________________________________________________________________________
State
Zip
E-Mail Address (if available)
Special Needs (please indicate)
Please circle applicable selections
| Full Conference(2 ½ days) Early Bird (before July 15, 2009) | Full Conference After July 15 | One day attendance | Annual NAPS Membership(after
May 1) | Total |
| $225—member | $260-member | $150
member | $25 | |
| $260-non-member | $310-non-member | $175 non-member | | |
Note: You may join the National Association of
Peer Specialists (NHAPS)now and receive the conference registration discounts. NAPS is a non-profit organization, Federal
I.D. # 30-0293174, and is registered with the CCR for federal agencies.
Payment must accompany registration. Checks should be made payable to “NAPS” and
sent with the registration form to: NAPS, 755 Alta Dale, Ada, MI 49301.
To pay by credit card, please provide the following:
Name on Card_________________________________ Phone #________________
Card #____________________________________
Security Code (3 or 4 digits) on reverse__________Expiration
Date ____________
