NONVERBAL LEARNING DISABILITIES

CHICAGO, ILLINOIS

September 24-25, 2001

 

  

 

CONFERENCE REGISTRATION FORM   

(Please complete a separate form for each attendee)


PLEASE PRINT

Title:         Dr.       Mrs.       Ms.       Mr.      (please circle)

Last Name: ____________  First Name: ____________

Home Address:  _______________________________

____________________________________________

City / State / Zip  ______________________________

Home Telephone:  (      )  ________________________

Business Name: _______________________________

Business Address:  ______________________________

____________________________________________

City / State / Zip  ______________________________

Business Telephone:  (      )  ______________________

Fax:  (     )  ___________________________________

E-mail address: ________________________________

 

Please circle:    Psychologist     Psychiatrist     Teacher
                      Parent             Administrator   Student
                      Other (please specify): _____________

 

Please register me for the following (circle):

Day One (only)
Drs. Byron Rourke & Warren Rosen - $150.00
(lunch included)

Day Two (only)
Sue Thompson & Dr. James Loomis - $150.00
(lunch included)

Day One AND Day Two - $245.00
(lunch included both days) 


Please make check payable to Dr. Dean Mooney. Due to the expected interest level, seating will only be reserved once your FULL payment has been received. (Check, money order, or purchase order constitutes full payment).

Refunds: Requests for refunds must be made in writing. A full refund, less a $50 service charge, will be made for requests postmarked by September 3, 2001. No refunds will be made thereafter.

Dr. Dean Mooney is not responsible for any presenter’s or participant’s statements, acts, materials, or omissions. The use of audio or video taping devices is NOT permitted.

Books authored by the presenters will be sold each day  - (CASH or CHECK only for all books).

If you have any special dietary needs or if you require special accommodations due to a disability, please contact the office by September 3, 2001, so that we may provide you with appropriate service.

Parent Dinner: On Monday evening, there will be an optional parent dinner held at the hotel. Parents, their friends and family are encouraged to attend. Pamela B. Tanguay, co-developer of NLDontheweb.org and author of NLD at Home:  A Parent’s Guide will host a question and answer session immediately following the dinner. You will have an opportunity to submit written questions upon registration. 

 

The cost of this dinner/Q&A session is NOT included in the conference registration but was introduced at the suggestion of parents, who find the contacts made here to be a tremendous support LONG after the conference is finished. Additional details will be provided on site. For planning purposes, please indicate below if you are interested in attending the dinner, by circling the appropriate response.

PARENT DINNER:           YES           NO

 


MAIL THIS REGISTRATION FORM &
FULL PAYMENT (CHECK OR P.O.#) TO: 

Dr. Dean J.M. Mooney
270 Olde Pine Lane
Wallingford, VT 05773-9203

 

DIRECT ANY QUESTIONS TO: 

Phone/Fax:  (802) 446-3577
E-mail:        ljmooney@vermontel.net

 

Note:  APA APPROVED - 6 c.e.u.'s for each day.

 

 

IMPORTANT CONFERENCE INFORMATION FOR ATTENDEES 

All confirmation packages (which will include directions) will be mailed on Friday, August 31, 2001. Prior to this you should assume that you are registered unless your check is returned to you immediately upon its arrival at our office. If you have NOT received your confirmation package by Friday, September 7, 2001, you should contact the office (802-446-3577) to ensure that your registration information was received. 

 

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HOTEL RESERVATIONS

To ensure availability please book your room TODAY!

 DOUBLETREE GUEST SUITES
2111 Butterfield Road

Downers Grove, IL  60515
(630) 971-2000

  Special Conference Rate $122.00 per night (single or double)

A limited number of rooms are being held at this discounted rate.  Be sure to book your room EARLY and mention the NONVERBAL LEARNING DISABILITIES conference.

  (Note: Cab fare from O'Hare Airport to the Doubletree is approximately $26, with American Taxi.)

 

CONFERENCE LOCATION

ABBINGTON DISTINCTIVE BANQUETS
35002 Route 53
Glen Ellyn, IL  60137
(630) 942-8600

The ABBINGTON is located 1/4 mile from the Doubletree…for those staying at the hotel, a complimentary shuttle service will be provided between the hotel and the ABBINGTON.

 

  

Conference flyer    Click here for more detailed information about the speakers and their presentations.

 

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