Transgender Training for Counselors and Educators

TRANSGENDER TRAINING FOR COUNSELORS AND EDUCATORS

NAVIGATING ETHICS, LEGALITY, AND STUDENT/CLIENT CONCERNS

FRIDAY, SEPTEMBER 30th, 2016

8:30 a.m. – 5:00 p.m.

Auburn University Montgomery

Contact Jennifer Bradley - Phone: (334) 244-3469 - Email:

Sponsored by ALCA Chapter VII - The ALCA Division of College Counseling - The AUM Counseling Center

REGISTRATION AND RESERVATIONS

Name:
Email:
Phone Number:
Organization:
Address:
Counseling License Number (If seeking CE's):

REGISTRATION TYPE & FEE - Please check ONE option that applies to you

□  $FREE - AUM CURRENT EMPLOYEE OR STUDENT REGISTRATION

(I am a current employee or student of AUM)

□  $40.00 - ALCA MEMBER REGISTRATION

( I am a member of the ALCA - Alabama Counseling Association)

□  $50.00 - GENERAL REGISTRATION FEE: I am none of the above

(I am not an AUM employee or student or a member of the ALCA)

NBCC CE's *This is an additional charge only for LPC's or ALC's who are requesting CE's for licensure requirements.

□  YES, I NEED DOCUMENTATION OF CE'S FOR THE NBCC ($20.00 - not included in the registration fee)

NBCC CE's are provided by The Counseling Clinic: Provider # 6779

□  NO, I DO NOT NEED NBCC CE'S.

DOCUMENTATION:

Do you require any documentation for attendance or continuing education? Check ALL that apply.

□  I require a Certificate of Attendance.

□  I require a Certificate of completion of NBCC Contact Hours.

□  I do not require any documentation.

PAYMENT OPTIONS:

MAKE checks PAYABLE to "THE COUNSELING CLINIC"

MAIL CHECKS TO: AUM Counseling Center P.O. Box 244023, Montgomery, AL 36124-4023)

Mail checks by September the 22nd.

□  I will pay for my registration and/or CE's by check or cash upon arrival at the training.

(No Credit Cards accepted)

□  I will mail my check for registration and/or CE’s prior to the training

□  I am a current AUM community member and am not required to pay for registration. I understand I must pay for CE's.

LUNCH RESERVATIONS:

PLEASE CHOOSE ONE OPTION BELOW. During the conference we will be providing a working lunch during a panel discussion. Please indicate whether you will be requesting a lunch. (FYI - Lunch will be assorted sandwiches and wraps (ham, turkey, and beef), chips and drinks.) Please note any dietary issues below.

□  NO, I do not need to reserve a lunch

□  YES, I would like to reserve a lunch. I DO NOT have any dietary restrictions that need accommodation.

□  YES, I would like to reserve a lunch AND I HAVE a dietary restriction. I will email the AUM Counseling Center regarding my specific request within three days of the training.

ACCOMMODATIONS:

Do you have an accommodation request that you need to discuss?

□  Yes, I have a request and would like to discuss it prior to the training. I will contact the AUM Counseling Center at 334-244-3469 or by email at prior to the training to discuss this request.

□  No, I have no accommodation requests.