13th Annual Addiction Conference Registration Form Logo
Conference Registration

13thAnnual Addiction Conference
Please register me for the Getting in Tune: Harmonizing the Field of AddictionConference taking place Friday, March 08, 2013at the Atlantic City Convention Center. NJPN will validate parking fee.

Registration Fee :
Registration Fee : Registration: $100.00
Registration Fee : Includes workshops, continential breakfast, lunch, and conference materials.

Attendee Information
* Required Information
*First Name:   *Last Name:
Organization:
*Mailing Address:
*City:   *State:   *ZIP:   *County:
*Email Address:
*Confirm Email Address:   *Phone:
*Conference Lunch Information:
Note: Specific details about lunch menu will be posted on NJPN website as it becomes available. Please know the caterers cannot address all special dietary requirements. If you do have a health-restrictive diet, for your safety, NJPN recommends bringing supplemental food with you to the conference.
*Do you need a sign language interpreter?
*What is your Agency's primary focus:



*Are you a member of your Local Municipal Alliance?
Demographic Information (Optional)
Gender:
Age:
Please select one of the following that best describes you:



Payment Information

NJDHTS Logo
SOLD OUT
The New Jersey Division of Highway Traffic Safety (NJDHTS) has developed a special conference track. Scholarships are available for individuals that will commit to attending the designated NJDHTS workshops. The deadline for submission is Friday, February 22, 2013(or sooner, if registration capacity is reached or all available scholarships are fulfilled.)
Payment
Conference registration, will be accepted only if full payment, including full payment of purchase orders, is received prior to the cut-off dates indicated on conference/training materials (Friday, February 22, 2013). Full payment must be received in order for registration to be considered complete and space reserved. No Refunds on cancellations received after Friday, February 22, 2013. All cancellations received after this date and/or no shows will still require full payment. For Substitution, Cancellation, and Refund policies, please consult Conference FAQ page, at njpn.org.