NYSSCA

NEW YORK STATE SCHOOL COUNSELOR ASSOCIATION

ANNUAL CONFERENCE: October 31-November 1, 2014

“SchoolCounselors: Informed, Accountable, Impactful”

The Albany Hilton, 40 Lodge Street, Albany, NY 12207

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 ► Special Event...Join us for a College Tour and Dinner at The College of Nanoscale Science and Engineering. 5:30-8:00 PM. Preregistration Required. First 50 to register can attend. I would like to attend the tour/dinner 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 3, 2014 / $225 / $275 / $205 / I will only attend my scheduled presentation
Regular/On-Site Registration / $250 / $300 / $230 / $140
Attending both days
Friday Only / $145 / $195 / $135 / $ 70
Saturday Only / $145 / $195 / $135 / $ 70
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 10/24/14. You may substitute a colleague by 10/30/14.

§  Conference and hotel information at www.nyssca.org

§  Make room reservations directly with the Albany Hilton 1-800-HILTONS (445-8667) or www.hiltonalbany.com. Use conference code 1NYSSC for the conference room rate.

§  Send conference questions to

§  Send registration questions to: Roger Forando, Registration Chair, at

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