Registration:
Getting What Kids Need:
Making a Difference in the Life of a Child
Registration Deadline May 26, 2006
Space is Limited to 600
Register before May 26th, pay $35.00 for the first person and $20.00 for each additional person from your agency. After May 26th all registrations are $50.00 (Registration includes continental breakfast and lunch)
Please print the following form with your information as it should appear on your badge
and in the conference directory. Please feel free to copy this form for additional attendees.
Fax 978-777-9454 or mail to ECCF, 15 Cherry Street, Danvers, MA 01923
NAME:______________________________________________________
TITLE:_______________________________________________________
ORG:_________________________________________________________
ADDRESS:____________________________________________________
CITY/ST/ZIP:_________________________________________________
PHONE:______________________________________________________
FAX:_________________________________________________________
EMAIL/WEB:__________________________________________________
(Directions are available at www.endicott.edu/servlet/RetrievePage?site=endicott&page=Directions)
Workshop Selection
(choose one from each session)
Morning Session 10:3012:00______________1-10
Afternoon Session 2:304:00______________A-J
If your agency would like to reserve space in the Expo to display information about your program(s), please email your contact information by May 26th to Kathy Colbert at k.colbert@eccf.org
Payment method please circle one
Check Credit Card: VISA MC
Card #____________________________________
Expiration date:______________________________
Signature:___________________________________
For more information:
Phone: 978-777-8876 Fax 978-777-9454
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