New York State School Counselor Association

NYSSCA

NEW YORK STATE SCHOOL COUNSELOR ASSOCIATION

ANNUAL CONFERENCE: November 20-November 21, 2015

“SchoolCounselors: Advocating Access for All”

The Sagamore Resort, 110 Sagamore Rd., Bolton Landing, NY 12814

PLEASE PRINT CLEARLY!

§  One registration form per person. This form must be accompanied by full payment or purchase order.

FIRST NAME ______LAST NAME______

§  Email address ______Telephone: (include area code)______

(Required for confirmation)

►PREFERRED mailing address: School/Work (Include school name) Home

§  If work: School: ______

§  Street address: ______

§  City/town: ______State: ______ZIP: ______Region/County:______

► Position Title: ______

► Elementary Middle School High School Administrator Director Grad Student Counselor Educator

►Are you currently a NYSSCA Member?* Yes No ►ASCA Member? Yes No

*NYSSCA Membership must be current through December 2014 to qualify for membership rate.

► Are you a first time conference attendee? Yes No

CHECK ONE CONFERENCE TYPE

Registration includes:
Friday and Saturday breakfast and lunch and conference materials / NYSSCA
Member / Non-Member
Fee includes 1 year membership / Graduate Student
Includes 1 year membership / Presenter
Early Bird Registration
Postmarked by October 16, 2015 / $235 / $285 / $225 / I will only attend my scheduled presentation
Regular/On-Site Registration / $260 / $310 / $235 / $155
Attending both days
Friday Only / $160 / $205 / $150 / $ 85
Saturday Only / $145 / $195 / $140 / $ 75
Graduate School: ______
Advisor’s Signature ______
Volunteers APPROVED ONLY / $155.00

§  Checks and purchase orders must be payable to NYSSCA.

§  Mail completed registration form with full payment by check OR authorized purchase order to:

NYSSCA; P.O. Box 217; Leicester, New York 14481: Attention Registration Chair

§  No refunds unless requested in writing prior to 11/12/2015. You may substitute a colleague by 11/18/2015.

§  Conference and hotel information at www.nyssca.org

§  Make room reservations directly with the Sagamore (866-384-1944) or www.thesagamore.com. Use conference code NYSSCA2015 for the conference room rate.

§  Send conference questions to

§  Send registration questions to: Sandra Braun, Registration Chair, at

§  *Check your membership renewal date when signing in on our website OR email inquiries to