OSEP National Parent Center Conference
High Expectations, Endless Possibilities

General Information

Name:
Organization:
Address:
City: State: Zip:
Phone (w):
Fax:
E-mail:

Registration Status

• Parent center director/representative ($275) ($325 after December 10 registration deadline)
• Parent center additional person ($275) ($325 after December 10 registration deadline)
• Professional/Others ($400) ($450 after December 10 registration deadline)
• OSEP

Hotel

Hotel rates are $205 plus 10.5% tax for a single or double room. The National Parent TAC will pay for the cost of a shared double room for one Parent Center representative for the nights of January 27–30. If you would like a single room you will be responsible for ½ the cost of that room per night. Those paying their own way should reserve rooms through the National Parent TAC for the conference rate.

• Yes, I need a hotel reservation
• Yes, I need an accessible hotel reservation

I will need a room for the nights of:

• Tuesday, January 27
• Wednesday, January 28
• Thursday, January 29
• Friday, January 30
• No, I do not need a hotel reservation

Smoking Preference (Availability limited and not guaranteed):

• Smoking
• Non-smoking

Please check one of the following:

• I have a roommate preference, please room me with:
  Name: Organization:
• I have no roommate preference, please assign me a roommate
• I would like a single occupancy room (responsible for any additional costs)
• I would like a double occupancy room (responsible for any additional costs)

Additional Accommodations

Please mark any special dietary needs. If other, please be specific.

• Vegetarian
• Other:

Do you need a sign language interpreter? Yes

If you are in need of other accommodations, please contact the National Parent TAC no later than Wednesday, December 10.

*Please note that you are responsible for your own transportation costs.