Bullying Prevention: Promoting Relationships and Eliminating Violence in School, Clinical and Community Settings
Friday November 7, 2008, 8 am - 4pm
Space is limited; register early!

Name

Title

Institution Or Organization

Work Address

City / State / Zip

/ /

Work Phone

E-mail

Registration fee: $80 $50 (Student)
Conference proceeds will benefit The Melissa Institute for Violence Prevention and Treatment.

Payment method:
 Purchase Order number (Please mail copy of registration to guarantee reservation.)

 Credit Card:
American Express
MasterCard
Visa
Discover
Diners Club

Card Holder Name

Account No.

Expiration Date

/

Specialty professional credits required: LICENSE #
Florida Board of Psychological Examiners Florida State Board of Nursing
Miami-Dade County Public Schools Florida Board of CSW, MFT and MHC
 AMA/PRA CME
Cancellations must be sent in writing and postmarked by September 14, 2007, to receive a refund of the registration fee, less a $10 administrative fee. Cancellations postmarked after September 14 will forfeit the registration fee.

Home About Us Articles Community Conferences Consultation Downloads Education Calendar How You Can Help Related Sites Scholarships Email