Together we can solve the puzzle

South Carolina Autism Society

Workshop Registration Form

* All Fields Required.
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* Your Name
* Your Address 1
Your Address 2
* Your City    * State       * Zip Code   
* Phone Please include area code.
* Your E-mail (Changes will be sent by email.)

Are you a:

YES

NO

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YES

NO

Select Sessions You Wish to Attend:

Select Workshop

Session Name

Location

Date

No Refunds
After Date

Fee Includes
Lunch:

Registration
Fee

Behavior Analysis for Lasting Change (9:00pm-4:00pm)

Columbia Conference Center
169 Laurelhurst Ave.
Columbia, SC

09/03/08

8/20**

Yes

$65

Becoming a Parent Trainer with Visual and Environmental Supports (6:00pm-8:00pm)

SCAS HQ
West Columbia and
SCATP Midlands Center
in Columbia (10/6)

9/15, 9/22, 9/29, 10/6, 10/20, +

9/9*

No

$20*

I will commit to helping train others - waive my $20 registration fee.

Navigating the Social World (9:00am-4:00pm)

Columbia Conference Center
169 Laurelhurst Ave.
Columbia, SC

02/20/09

2/06

Yes

$75

* Cancellation fee ( if cancelled before refunds date above) $10/session
** Cancellation fee ( if cancelled before refunds date above) $20/session

A limited number of Scholarships for PARENTS are available at no cost for some workshops. Early requests are strongly recommended. Scholarship requests also can be faxed (print this form including pertinent information and fax it to 803-750-8121).