Mental Health Association in Tulsa

Zarrow Symposium Overview

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Conference Agenda

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Continuing Education

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To receive conference updates on speakers, schedule, and more, please provide us with your email address:

EARLY BIRD REGISTRATION DEADLINE - September 2, 2008

2008 Zarrow Mental Health Symposium
RELATIONSHIPS
September 18-19, 2008
Tulsa Marriott Southern Hills
1902 East 71st Street
Tulsa, Oklahoma

Title

First Name

Last Name

Occupation/Title

Organization

Address

City/State/Zip

Phone

Area Code

Fax

Area Code

Cell Phone

Area Code

Continuing Education Credit:
If you are requesting Continuing Education Credit for your attendance, check the appropriate professional field(s):

CME (physician)
Psychologist
LCSW
LPC
LMFT
CADC
LADC
CRC
CRSS

Other

LBP*

*LBP Credits will be applied for. Please check with the LBP Licensure Board, or check the conference agenda for updates on approved sessions.

REGISTRATION	Early Bird - on or before 9/02/08	Regular - after 9/02/08
Full Conference - 14.25 CEUs	$150	$195
Thursday Only - 7.25 CEUs	$90	$115
Friday Only - 7.0 CEUs	$90	$115
*Student - Full Conference**	$85	$100
*Student - Thursday Only**	$45	$60
*Student - Friday Only**	$45	$60

* To qualify for the student rate you must submit a photocopy of your current student identification card, and if you are a college or graduate student, submit proof of enrollment in at least nine credit hours for the 2008 fall semester. Fax to: Zarrow Registration, (918)585-1263, or mail to: Zarrow Registration, Mental Health Association in Tulsa, 1870 S. Boulder, Tulsa, OK 74119-5234.

Please indicate your workshop preferences (see conference agenda for titles and descriptions):

THU 9/18 Session 1 1:45 - 3:15	THU 9/18 Session 2 3:30 - 5:00	FRI 9/19 Session 3 10:30 - 12:00
1-A 1-B 1-C 1-D 1-E 1-F 1-G 1-H 1 - I	2-A 2-B 2-C 2-D 2-E 2-F 2-G 2-H 2 - I	3-A 3-B 3-C 3-D 3-E 3-F 3-G 3-H 3 - I

PAYMENT

Please note, to qualify for the early bird registration rate, payment must be received on or before September 2, 2008. If paying by purchase order (PO), you must mail or fax a copy of the purchase order with the names of the attendee(s) included on the PO.

Payment Type

Name on Card

Card Number

Expiration

Month Year

Card ID Number

We request your Card ID number for your protection. It is a unique number that can only be found on your credit card. For Visa or MasterCard, it is the last 3 digits located on the back of the card.

SPECIAL NEEDS
Please indicated any special needs you may have. Conference organizers will contact you for specifics. Please register by September10th if special accommodations are needed.

Vegetarian meals
Assistance for the hearing impaired
Wheelchair access
Other

Additional Comments

CANCELLATIONS/REFUNDS
A complete refund for conference registration fees will be made ONLY if we receive WRITTEN notice by September 10, 2008. Refund fees are not transferrable to future events.

Download a PDF version of the registration form
and conference agenda