ADVIP Conference Registration by Mail

This form may be used for registration payments by mail.
For online registrations using PayPal or credit / debit card, please visit this page.

August 29, 2020 International Conference

Registration

Please complete the information below to register for the conference. A copy of the form will be mailed to the email address you supply.

Print this emailed form and mail with check or money order payable to ADVIP to:

John Hamel, ADVIP Conference Chair
28 Upper Oak
San Rafael CA 94903
U.S.A.
If you have any questions, please email johnmhamel@comcast.net
Name*
First Last
Organization
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Number of Attendees*
Check one:*
- Conference Registration - Early Bird (before June 1) - $140.00
- Conference Registration - $160.00
- Conference Registration - Current ADVIP Member - $125.00
- I have already registered ($0)
Continuing Education Credits*
- Early Registration CEU - $45
- At the Door CEU - $55
- No CEU
If you would like to earn CEU for attending the conference, please check the appropriate box and this will be added to your registration fee.
Total

Association of Domestic Violence Intervention Providers