Registration Form

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Select One Column for Each Person Staying at Lake Yale

Participant’s Name & Position Reg. Fee

Campus*

or Campus*

Total

(4)

1.

2.

3.

4.

5.

6.

Check or POs Made Out to FAPT Enclosed For (TOTAL):

(5)

(1) Includes materials and lunches and must be paid by ALL participants.

(2) Cost for persons staying in a motel room at Lake Yale (Sunday - Thursday; four nights).

(3) Cost for persons staying in a motel room at Lake Yale (Monday - Thursday; three nights).

(4) Add costs across the row for each participant.

(5) Add costs for all participants down the column (mandatory).

Because we must guarantee participant count, there can be no refunds for cancellations; however, substitutions can be made

prior to the training meeting. Prepayment is required for participation; please ensure that all participant payments have been

remitted prior to attending the training meeting. In order to properly account for all payments addressed to FAPT, please

imprint onto your check or purchase order the wording "Lake Yale" to reference the Lake Yale meeting.

ALL CHECKS AND POs MUST BE MADE PAYABLE TO FAPT AND RETURNED TO THE ADDRESS BELOW.

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Please complete the registration form and questionnaire and return no later than March 6, 2006, to (new

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FAPT office address):

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Attn: Diane Bennett, Director

P. O. Box 1686

Fax No. (850) 245-9935

*Please note that ALL persons staying on site will be expected to share lodging (double occupancy) unless other arrangements are specified.

Private

single room rates per person, including registration

: Sunday–Thursday ($350) / Monday–Thursday ($290).

Director’s Signature: ____________________________________________