2021 NACAC Conference Registration Form (US Currency)

Note to form maker. The starting instructions are on the web page so don't include them here.

Registrant*

First Last

Agency/Organization (if applicable)

Email*

Provide the email address you will use to log in to the online conference. Your confirmation will be sent to this email.

Enter Email Confirm Email

Address*

If your address is in Canada, go to the top of the page and click on the 'Canadian registration form'. All rates on this current form will be charged in US dollars.

Street Address City State / Province / Region ZIP / Postal Code Country

This address is my:*

Office
Home

Phone*

Administrative Email

To send a duplicate copy of your registration receipt to someone else enter a different email address below. This is for an administrative assistant or a financial contact and is usually left blank.

Parenting Partner*

I have a parenting partner registration to enter. Only for couples who are or will be raising a child together and will be viewing the sessions together. There is no additional fee for parenting partners who are watching the sessions together.

yes
no

Parenting Partner Information

If your parenting partner will be watching with you, enter their name below. You will receive one unique sign-on.

First Last

Partner Email

Partner Organization (if applicable)

I am a/an:

Check all that apply to the attendees on this registration form.

Adoptive or foster parent
Kinship care provider
Adoption or child welfare professional
Adoptee or person who has been in foster care
Prospective adoptive or foster parent
Birth parent whose child was adopted or in care
Other (please specify below)

Other

Is this your first NACAC conference?

yes
no

Do you plan to attend some of the lunch time discussions?

yes
no
maybe / don't know yet

Do you need any special accommodations (such as closed captioning or ASL interpretation) to participate in the online NACAC conference?

yes
no

Please explain the accommodations you need*

Membership*

NACAC members receive a discount on conference registration fees. If you are not a current member, you can apply for or renew your membership now and use the discounted rate. If you are not a member and pay the non-member rate for a 3- or 4-day registration, you will receive a one-year individual NACAC membership.

I am not a NACAC member
I would like to join today or renew an expired membership
I am a current NACAC individual/family member
I work for a current organizational or national/corporate member
I represent a group that is a current NACAC parent group or enhanced parent group member

Enter the group name and/or member number of your current NACAC membership.

Join or Renew NACAC Membership

All rates are in US dollars.

$45 Individual/family membership (discount for one registration)
$45 Parent group membership (discount for one registration)
$200 Organizational membership (discount for up to 20 employees)
$200 Enhanced parent group membership (discount for up to 20 parent affiliates)
$1000 National/corporate membership (discounted registration for all employees)

Join or Renew NACAC Membership

All rates are in US dollars.

$50 Individual/family membership (discount for one registration)
$50 Parent group membership (discount for one registration)
$220 Organizational membership (discount for up to 20 employees)
$220 Enhanced parent group membership (discount for up to 20 parent affiliates)
$1100 National/corporate membership (discounted registration for all employees)

Registration Type and Fees

Rates are based on the number of days you choose.

For current NACAC members (including those who just joined above):
• 4-day registration is $240
• 3-day is $195
• 1- or 2-day is $150

Nonmember rates are $50 more.

All rates are in US dollars.

Registration*

Select the days you will attend.

Tuesday, July 20
Wednesday, July 21
Thursday, July 22
Friday, July 23

Tuesday Count

Please enter a number from 1 to 1.

Wednesday Count

Please enter a number from 1 to 1.

Thursday Count

Please enter a number from 1 to 1.

Friday Count

Please enter a number from 1 to 1.

Number of Days Attending

Full Conference - Individual - Nonmember

Price: $290.00

Three Day - Individual - Nonmember

Price: $245.00

Two Day - Individual - Nonmember

Price: $200.00

One Day - Individual - Nonmember

Price: $200.00

Full Conference - Individual - Member

Price: $240.00

Three Day - Individual - Member

Price: $195.00

Two Day - Individual - Member

Price: $150.00

One Day - Individual - Member

Price: $150.00

You only selected 1 day. The fee is the same for 1 or 2 days so you may want to add another day even if you cannot attend that day live.

Student Discount

I am a full time student and would like the student discount

Check this box if you are a full-time college or graduate student (9 hours or more). Email a copy of your ID and current transcript to info@nacac.org. You will be able to deduct 50 percent from your registration fees, but not membership. If you are using the student discount, you can pay for your registration fees after the NACAC office has verified your student status.

Full Conference - Student - Member

Price: $120.00

Three Day - Student - Member

Price: $92.50

Two Day - Student - Member

Price: $75.00

One Day - Student - Member

Price: $75.00

Full Conference - Student - Nonmember

Price: $145.00

Three Day - Student - Nonmember

Price: $122.50

Two Day - Student - Nonmember

Price: $100.00

One Day - Student - Nonmember

Price: $100.00

Workshops

Please choose the workshops you plan to attend live. You will receive access to recordings for all workshops on the days you register for. Please note that you do not need to let us know if your plans change; these choices are for our planning purposes only. (Only the periods that have two breakout sessions are listed below. The other five periods have a single keynote session and you will automatically have access to those sessions.)

Period 1, Tuesday, July 20

1A — Building Organizational Capacity for LGBTQ Inclusive Practice, Nia Desiré Clark, BSW, Human Rights Campaign Foundation, District of Columbia
1B — Looking Forward for Recruitment, Denise Goodman, PhD, trainer/consultant, Ohio

Period 3, Tuesday, July 20

3A — Rethinking Adoption Recruitment in the Black Community: Examining Engagement Along the Continuum, Deborah Burrus and Evangel D. Wicks, Georgia Division of Family and Children Services, Georgia
3B — Preparing Families for Success: Focusing on the Child’s Experiences and Needs, Kim Stevens, M.Ed., North American Council on Adoptable Children, Vermont

Period 4, Tuesday, July 20

4A — Helping Older Youth in Care Transition to Adulthood, Nathan Ross, adopted person/consultant/trainer, Missouri
4B — Making Your Support Services for Foster, Adoptive, and Kinship Families More Effective, Britt Cloudsdale, AdoptUSKids, North Carolina and Alicia Groh, MPP, AdoptUSKids, Minnesota

Period 5, Wednesday, July 21

5A — Identity and Belonging for Adoptees, Dianne Mathes, RSW, Adoption Council of Ontario
5B — Lessons from the Toughest Cases: Working With Attachment Issues and Complex Trauma, Karen Buckwalter, MSW, LCSW, Chaddock, South Carolina • Lori Thomas, Emmaus Family Counseling Center, Virginia

Period 7, Wednesday, July 21

7A — Fetal Alcohol Spectrum Disorders from a Trauma Lens, Barb Clark, North American Council on Adoptable Children, Minnesota
7B — Virtual Family Finding Strategies: Locating Kin through Databases, Social Media, and Great First Impressions, Jennifer Townsend and Lori Ross, FosterAdopt Connect, Missouri

Period 8, Wednesday, July 21

8A — Straight Talk for Kids: Dealing With The Toughest Topics, Maris H. Blechner, MEd, LCSW, Maris Blechner Consulting, New York
8B — Ambiguous Loss and Adoption, JaeRan Kim, PhD, MSW, University of Washington Tacoma, Social Work and Criminal Justice program

Period 9, Thursday, July 22

9A — Their Story Isn’t Over: Parenting Children or Adolescents Who Act Out with Sexual Behaviors, Monica Cohu, Family Restoration Services, Missouri
9B — The Blanket of Permanency: Understanding the Journey, Karen Moore, RSW, Open Doors for Lanark Children and Youth, Ontario

Period 11, Thursday, July 22

11A — Historical Trauma: What It Is and How to Move Forward, Judge William Thorne, retired judge, Utah
11B — The Eye of the Storm: Preventing, Responding to, and Recovering from Family Crises, Sue Badeau, Badeau Family Books and Consulting, Pennsylvania

Period 12, Thursday, July 22

12A — A Neurodevelopmental Approach to Treating Complex Trauma, Robyn Gobbel, LMSW, private practice, Michigan
12B — The Couples Check-Up: Keeping Relationships Strong in the Adoption and Fostering Journey, Torrey Carroll, MA, LPC, & Nikki Carroll, MA, LPC, The TNC Psychotherapy Group, PLLC, Texas

Period 13, Friday, July 23

13A — The Strategies of Trust-Based Relational Intervention® (TBRI®), Daren Jones, LMSW, Karyn Purvis Institute of Child Development, Texas
13B — Advocating for your Child: Building an Informed Partnership with the School, Melissa Sadin, EdD, Ducks & Lions: Trauma Sensitive Resources, New Jersey

Period 15, Friday, July 23

15A — Ten Parenting Skills an Adoptee Wants Every Parent to Know, Jeanette Yoffe, MFT, Yoffe Therapy, California
15B — Transition Mountain: A Team Approach, Heather Richardson, adoptive parent, Ontario • Terra Bovingdon, MSW, RSW, family and child therapist, Ontario

Continuing Education and Certificate of Attendance

All attendees will receive a certificate of attendance at no cost.

Attendees can also purchase social work continuing education hours (CE) for live sessions attended of up to 26 hours for the four days.

CE is $40 and you will pay that when submitting a CE form at the conclusion of your participation in the conference.

Additionally, any sessions attended by recording will be eligible for social work CE from a different licensing board and will require a post-test for each session submitted.

CE credits take approximately 4 weeks to be processed.

Further information about CE is here: USE CORRECT LINKhttps://www.nacac.org/get-training/conference/sessions-and-workshops/

Payment

Please note that fees are non-refundable. If you cannot attend live or view the recordings, you can ask to have the registration transferred to someone else.

If you are paying by check, we must receive the payment or an organizational purchase order at least one week before the conference.

You have registered as a current NACAC member. If that is incorrect please change your answer to the membership question above.

You have registered at the nonmember rate. If that is incorrect please change your answer to the membership question above.

You have registered as a full time student at the nonmember rate.

You have registered as a NACAC member and full time student. If that is incorrect please change your answer to the membership and/or student discount questions above.

You are attending all 4 days of the conference.

You have registered to attend 3 days of the conference.

You have registered to attend 2 days of the conference.

You have registered to attend 1 day of the conference. For no change in price, you can choose one more day above to attend and receive the workshop recordings.

Total

$0.00

Payment Method

Please choose the method of payment.

Why is no payment due?*

(Please note, if your agency or another entity is paying the registration at a later date, choose "Agency Check or Purchase Order" above as the payment method instead of "No Payment Due".)

I am a presenter and I or my organization have a current NACAC membership
I am a NACAC representative with a current NACAC membership
Other reason

In the box below, tell us why no payment is due.*

(If your agency or another entity is paying the registration at a later date, choose "Agency Check or Purchase Order" above as the Payment Method instead of "No Payment Due" so we get the right information.)

Designated Group Code*

This payment type is for registrants who have been given a specific code. If you were given a code, enter it below. If you do not have a code, choose a different payment type above. If your agency or another entity is paying the registration at a later date, choose "Agency Check or Purchase Order" above as the Payment Method.

Make checks out to NACAC and mail to:
NACAC
970 Raymond Ave Ste 106
Saint Paul, MN 55114

Make payment out to NACAC and mail to:
NACAC
970 Raymond Ave Ste 106
Saint Paul, MN 55114

Payor Name*

What is the name of the agency staff who will be generating (or responsible) for the payment?

Payor Organization

Payor Email*

Payor Phone Number

Anything you would like us to know about this registration or payment?

(if no, leave blank)

Credit Card

You will receive an email confirmation of your registration and payment.

Card Details

Cardholder Name

Please Note

If you are not re-directed to a confirmation web page after you click on the Submit button, you have NOT successfully registered. Scroll through the page to determine what information is missing and re-submit. You will receive an immediate email confirmation of your registration and payment.

Name

This field is for validation purposes and should be left unchanged.

2021 NACAC Conference Registration Form (US Currency)

Registration Type and Fees

Workshops

Continuing Education and Certificate of Attendance

Payment

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