Retreat Registration


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CALL 1-800-611-7555 to register by phone or email [email protected] Mail registration to: CARE Connections/SOCC Att: RBTL 1988 Newmark Ave Coos Bay, Oregon 97420

CARE Connections Retreat by the Lake XVI June 2oth and 21st, 2014 — Registration Form —

PRINT Name:__________________________________________ Address:______________________________________________________________________

Lodging at the Dorms at SWOCC ______ I will not be staying in the dorms.

______ I will be staying in the dorms. _____ Friday

_____ Saturday ($36)

City:_________________________________ State:__________ Zip:______________________ Phone:________________________________________________________________________ Email:_________________________________________________________________________

Room-mate request_________________

Conference Fees: $100.00 per person (includes lodging on Friday Night) Breakfast, Snacks and Lunch provided on Friday & Saturday. Dinner is on your own. Please register before June 20th. You may pay the conference fee at the door.

____ I will be attending Dr. Stephen J. Bavolek’s presentation, June 20th, 10am - 5pm (6 hours, SET 2 pending) Breakfast and Registration begins at 8:30am on June 20th _____ I will be attending the Keynote Presentation, June 20th, 6:30pm - 8:30pm (2 hours, SET 1) Tom Udell from Western Oregon University Child Care Resource & Referral Central Coordination and Teaching Research Institute Saturday Workshop Choices (Please indicate 1st, 2nd and 3rd choices.) Indicate by session letter. 1st Choice 2nd Choice 3rd Choice Session 1:

__________________

__________________

__________________

Session 2:

__________________

__________________

__________________

Session 3:

__________________

__________________

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Payment Method: _____ Check _____ Money Order ____Scholarship _____ Visa _____MasterCard _____ Discover * Make checks Payable to: CARE Connections/SOCC * Account #____________________________________ * Your check is your receipt. * Exp. Date ________ Amount to charge ___________ * Please do not send cash. * Signature ______________________________________________________________________________ Sponsored by Oregon Association for the Education of Young Children (OAEYC) and Oregon Center for Career Development (OCCD) and the Oregon Community Foundation OAEYC Membership: Are you a member? NO YES If NOT you may join now!!! Go to www.naeyc.org to join or renew on-line or you may call: 1-800-452-3610 to get a membership form sent to you. OAEYC Members will get a $5.00 discount. We offer several choices at mealtimes. If you have special dietary needs, please bring your own special food. Vegetarian options will be available. Breakfast, Lunch and Snacks provided on Friday and Saturday.

If you need special accommodations such as interpreters, translators or special access, we must be notified by June 13th. Call 1-800-611-7555. Thank you!

CARE Connections Retreat by the Lake XVI “Nurturing Our Future” June 20th & 21st, 2014 OREGON STATEWIDE SCHOLARSHIP PROGRAM Oregon Center for Career Development If you:  Work directly with children at least 20 hours a week in an Oregon Child Care Division licensed (Certified or Registered) child care facility or a child care center legally exempt from licensing AND  Have an Oregon Registry Step 3 or above Scholarship awards may help pay your cost of $100.00 http://www.pdx.edu/occd/sites/www.pdx.edu.occd/files/2013-14_Community_Based_Training_Support.pdf Apply for your letter of eligibility today. Fill out the scholarship program application and professional development statement or contact the Oregon Center for Career Development or CARE Connections, Child Care MAIL SCHOLARSHIP APPLICATIONS TO: PSU-OCCD ATTN: Scholarship PO Box 751 Portland, OR 97207

OR FAX TO: 503-725-5430 ATTN: Scholarship

OR EMAIL TO: [email protected]

Join us and grow with our profession! If you are a Child Care Provider who is not yet on the Oregon Registry at a Step 3, and, therefore, do not qualify for the statewide conference scholarship, please call us at 541-888-7336 or email [email protected].

If you are having a financial hardship please contact us immediately.

Questions? 1-800-611-7555 [email protected] Southwestern Oregon Community College is an Equal Opportunity Educator and Employer.