Parent Leadership Training

Parent Leadership Training Registration

Registrant*

First Last

Email*

Address*

Street Address City State ZIP Code

Phone

Are there any dietary restrictions we should know about?*

Yes
No

Dietary Restrictions

Are you also registering a parenting partner for the training?*

Yes
No

Registrant 2: First Name

Registrant 2: Last Name

Registrant 2 Email

Registrant 2 Phone

Are you from outside the metro area and need a hotel room?*

Yes
No

Hotel Room*

Choose whether you would like to share a sleeping room (no cost for those outside the metro area) or have a private room (approximately $80/night which will be paid directly to the hotel).

Shared Room (2 to a room)-$0
Private Room about $80 per night

Which nights do you need a hotel room?*

Check all that apply.

Friday, November 8
Saturday, November 9

Friday night fee for private room

Price: $80.00

Saturday night fee for private room

Price: $80.00

Will there be anyone else in your hotel room?*

Yes
No

Provide any other hotel guest names so we can include them on our rooming list.

Total

This amount is approximate.

$0.00

Anything you would like us to know about this registration?

How will you pay for your private hotel room?*

Online
Check

NOTE TO FORM MAKER THIS IS HIDDEN UNTIL AMOUNTS DETERMINED. THE HIDING IS BY LOGIC NOT GOING TO ANY EXISTING ANSWERS.

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

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 different web page after you click on the submit registration button, you have NOT successfully registered. Scroll to the bottom of the page and determine what information is missing and re-enter and submit.

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

If you have any questions, please contact Ginny at ginnyblade@nacac.org.

Email

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

Parent Leadership Training

The training will include:

Cost

Date and Location

Meals

Hotel

Contact