LICAC 2011

Long Island Counselors' Annual Conference

Introduction

Workshops

Session I

Session II

Session III

Schedule

Registration

Directions

Committee

Exhibitor's Showcase

Sponsors

 
REGISTRATION
Registration fees for LICAC 2011 include membership in one of the sponsoring organizations — East End Counselors’ Association (EECA), Nassau Counselors’ Association (NCA) and Western Suffolk Counselors’ Association (WSCA).

If you are a current member (2011-2012) of one of the organizations, please send the members’ registration fee indicated in the dropdown below. If you have not yet renewed your membership for 2011-2012, or are a new member, please complete this registration form (which will also serve as your membership application), and send in the amount indicated for the organization you are joining.

Membership in all three organizations runs from July 1, 2011 to June 30, 2012.

To register online please complete the form below and click send. You must also select the correct registration price and complete the PayPal information. 


Last Name*
First Name*
Current Position*
Institution*
Business Address
City
State
Business Phone Number() -
Zip Code
Home Phone Number() -
Home Address
Home City
Home Zip
Home State
E-mail Address*
Session I Workshop Choice 1
Session I Workshop Choice 2
Session I Workshop Choice 3
Session II Workshop Choice 1
Session II Workshop Choice 2
Session II Workshop Choice 3
Session III Workshop Choice 1
Session III Workshop Choice 2
Session III Workshop Choice 3
I am a member of
I am joining
Conference Registration - Please Select One

Membership Only - Please Select One

To register by mail please print and mail the registration form.

Document
Student Registration		Document
Registration Form

For more information or questions, please call
(631) 209-1896.