Race and Equity Registration

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

Name*

First Last

Agency/Organization (if applicable)

Email*

Registrant's email address.

Enter Email Confirm Email

Administrative Email

If you are submitting this form on behalf of the registrant and want to receive a confirmation, enter your email address below. This is for an administrative assistant or a financial contact and is usually left blank.

Address*

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

Phone*

I am a/an:

Check all that apply

Adoptive/foster parent or kinship care provider
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

Do you need closed captioning to watch the recordings?

yes
no

Registration*

Rates are in US dollars.

The registration fee is the same whether attending all or part of the day.

Parenting partners who are watching sessions together pay a single registration fee.

$50 — NACAC member
$60 — Non-member

Membership*

To receive the discounted rate, let us know about your current NACAC membership.

If you are not a current member, you can apply for or renew your membership now and use the discounted rate or change your registration type above.

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)

Payment

Please note that fees are non-refundable but they are transferrable.

Total

$0.00

Payment Method*

Please choose the method of payment.

Credit Card
Agency Check

Payor Name*

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

Please note that we must receive payment or otherwise have confirmation of how and when the payment will be made before we will share links to the sessions.

Payor Organization*

Payor Email*

Payor Phone Number

Anything you would like us to know about this registration?

(if no, leave blank)

Credit Card

You will receive an email confirmation from nacacweb@nacac.org.

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.

Race and Equity Registration

Payment

Please Note

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The North American Council on Adoptable Children