NCPN Online Registration Form

Step 1 of 3 - Enter your information below then click the "Continue with Registration" button.

(required fields are marked with an asterisk)

* First Name: 
* Last Name: 
* First Name for Nametag: 
* Job Title: 
* Organization: 
* Address 1: 
Address 2: 
* City: 
* State or Province: 
* Zip: 
* Country: 
* Phone Number: 
   Ext: 
* Fax: 
* E-mail: 
 
Select the area that best describes your work:
K-12   Postsecondary   Adult Education   Workforce Development   Employer  
Other  
Also, if in education, choose one of the following:
CTE Faculty   Academic Faculty    Counselor/Advisor   Local/Regional Administrator/Coordinator  
State/Federal Administrator/Coordinator     Other  
PRECONFERENCE INSTITUTES, Sunday, October 12
Attendees can attend one full-day workshop or up to two half-day workshops (morning and afternoon).
Lunch is included for attendees of a full-day or two half-day preconference workshops.
Half-Day Preconference Institutes: 9:00 a.m. to Noon
Select one of the following.....
Rate $ Amount
   Are You Certified? Industry Certification and Credentialing
$125
$
  Technology -Infused Classroom
$125
$
  I will not be attending a workshop during this time period (Select this to deselect other options in this group)
 
   
Half-Day Preconference Institutes: 1:30-4:30 p.m.
Rate $ Amount
  Learning Today to LEAD Tomorrow
$125
$
  Technology-Infused Classroom (REPEAT)
$125
$
  Employer and Presidents Institute (Noon-5:00 pm, includes lunch)
$125
$
  LEGOLAND Florida Tour (1:00-5:00 pm. Includes boxlunch, bus boards at 12:10)
$150
$
  I will not be attending a workshop during this time period (Select this to deselect other options in this group)
 
   
 
Full-Day Preconference Institutes: 9:00 a.m. - 4:30 p.m. (includes lunch) Rate $ Amount
   Career Pathways Leadership Certification (must also attend main conference)
$250
$
   Career Pathways Effect Series: Counseling for Success
$250
$
   Career Pathways Effect Series: Teaching for Success  
$250
$
  Adult Career Pathways Leadership Certification
$250
$
  I will not be attending a workshop during this time period (Select this to deselect other options in this group)
 
   
 
Fees for Main Conference, October 13-14 (See agenda.)
  NCPN Member Nonmember Total Payment
Early Bird (deadline 7/15/14) $490 $530 $
Preregistration (7/16/14 through 10/03/14) $520 $560 $
Onsite Registration (after 10/03/14) $550 $590 $
     
ADDITIONAL FEES
NCPN Membership Fee (for new or renewing members) $75 N/A $
Nonmembers: Attend Members Lunch Tuesday N/A $40   $
If membership expires prior to 10/1/14, you must renew membership to take member discount. Contact llocke@cord.org for membership information. If joining on this form, please take member rate.
Spouse (includes receptions and exhibits only)     $60 NA $
Spouse Name:  

* Total Payment:

$  

Method of Payment:  (Tax ID # 74-2077794) (online registrations MUST be accompanied by credit card payment. If paying by check, registration must be mailed.

(click here for W-9)

*Credit Card: 
 
VISA  MasterCard   American Express
*Name on Card: 
 
*Card Number: 
*Exp. Date:
*Security Code:  
*I understand that payment must be included for this registration to be processed and have included credit card information to cover my registration. If paying by check, registration must be mailed.