Community College Baccalaureate Association, Conference

The BOOK

The Community College Baccalaureate
Emerging Trends and Policy Issues

CANADIAN FORUM

ACCC/CCBA
Pre-conference Forum
Saturday, May 24
Prince George

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Pathways to Success: Access, Affordability and Quality
Bachelors Degrees at Community Colleges: Denver
February 29 – March 2, 2008

* = Required Fields
Date
First Name *	Last Name *
Position/Title *	Name as it should appear on badge *
Institution/Association/Organization *	Mailing Address *
City *	State/Province *
Zip *	Country *
Phone *	Fax
E-Mail Address *

Please list additional registrants from the same institution below:
Name as it should appear on badge	Position/Title
Name as it should appear on badge	Position/Title

Registration Fees - Please select appropriate category: You may select to submit a membership application below and pay member conference fees.
Registration before January 28, 2008 Member - $375.00 per person Non-Member - $500.00 per person
Registration after January 28, 2008 Member - $425.00 per person Non-Member - $550.00 per person Notes: The above registration fees include all conference meals and the cocktail reception on February 29 that will be held with the National Association of Community College teacher Education Programs. Non-members will be given temporary membership status for one year. Registration may be canceled for a full refund up to thirty days before the conference. Cancellations made up to two weeks before the conference will be charge a $100 cancellation fee. Cancellations will not be accepts within two weeks of the conference.

CCBA Annual Membership - optional with conference registration Institutional Membership $500.00 - If submitting the institutional membership, all individuals attending the conference from the institution will receive the member registration rate.
Individual Membership $125.00

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Check attached
Charge Membership Fee

Card Holder Name	Billing Address
Expiration Date	Card Number
Visa
Mastercard


If you are mailing this form, please return this form with your check (Payable to Community College Baccalaureate Association) or credit card information to: Beth Hagan, Ph.D. Community College Baccalaureate Association c/o Edison Community College P.O. Box 60210 Fort Myers, Florida 33906-6210 If you pay by credit card, and do not want to use e-mail, you may fax your application to 239-947-8870. Note: The CCBA name will not appear on your credit card statement. The processing organization, Business Solutions of Naples will be shown.