CLHS Conference Registration

This is not an online registration form. To register, complete the form and then print it and mail or fax it to CLHS. Be sure to review the cancellation policy.

Purchase order registrations must include an actual copy of the purchase order.
Please make checks payable to CLHS and mail to 6615 E. Pacific Coast Hwy, Suite 120
Long Beach, CA 90803 or FAX to (562) 430-5607.

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1. Registration Information
Information will appear on name badge. For additional group registrations (from same school only), attach a second sheet with full name of each participant.

Name:

School:

School Address:

City State Zip:

District:

Telephone:

E-mail Address:

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2. School Safety Symposium Rates

$259 members $319 non-members

Summer Institutes

$269 members $329 non-members

Maui, Hawaii * July 8-11, 2008

Indian Wells, CA * July 27-29, 2008

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3. Membership (optional):

CLHS Institutional Membership: $295
Includes member rates for all staff at all CLHS/NHSA events, group discounts for the CLHS/NHSA Annual Conference, plus newsletters and resources

CLHS Individual Membership: $60
Includes member rates for all CLHS/NHSA events, plus newsletters and resources

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4. Payment

1. Total Conference Fees: $

2. Membership Fees (if any): $

Total Enclosed (add lines 1 and 2): $

Check - Payable to CLHS ($30 fee for returned checks)

Official Purchase Order - A valid copy of the purchase order must be included to be processed.

Visa / MC - Card #

Exp

I authorize CLHS to bill my credit card for $

Cardholder name (please print)

Authorized signature ________________________________________________
Please sign your actual signature above before sending.

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Registration Instructions
(Only purchase orders or credit card orders may be faxed.)

Regular Registrations - must be received with payment by mail or FAX in order to be processed.

On-Site Registration - after the "No Refund" date (see cancellation policy), you must register on-site (there is no additional cost). Payment by cash, check, purchase order, Visa or Mastercard will be accepted.

To ensure you have met strict payment deadlines, please:

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Cancellation Policy

Cancellations must be in writing and faxed to (562) 430-5607. Please call to verify receipt of cancellations at (562) 430-3136. A colleague may substitute for you at anytime to avoid cancellation penalties.

School Safety Symposium
Prior to 4/7/08 - Full refund; 4/7/08 to 4/13/08 - $60 fee
After 4/13/08 - No refund, but a colleague may substitute

Summer Institutes
Maui: Prior to 6/10/08 - full refund; 6/10/08-6/24/08 - $60 fee; after 6/24/08 - no refund.
Indian Wells: Prior to 6/27/08 - full refund; 6/27/08-7/11/08 - $60 fee; after 7/11/08 - no refund.

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