Illinois Foster and Adoptive Parent Association & Illinois Department of Children and Family Services presents
Empowering and Educating to Excel Conference
October 24 - 26, 2008, Chicago Oak Brook Marriott, Oak Brook, Illinois

Conference Registration Form

Directions:  Please enter your information below. Then print this conference registration form and mail or fax along with a copy of your ADA form. Couples attending this conference must each complete a conference registration form.  All registration forms must be received by October 10, 2008.  Space is limited, so early registration is advised.

You may return your conference registration by fax (217/557-4349) or mail (Station 122, 227 S. 7th St., Springfield, IL  62701).  All registered participants are expected to arrive at the conference before the opening session and attend the full 3-day conference.  Upon registration, you will receive a conference information letter from the DCFS Registration Unit.  You must follow the instructions in that confirmation letter to submit a credit card or other deposit to hold your hotel room until check-in.  If you have questions about this conference registration form, call the DCFS Registration Unit toll free at (877) 800-3393.

All Registrants—Complete this section.  Who are you?  CHECK ALL THAT APPLY.
Foster Caregiver      Relative Caregiver      Adoptive Parent    Guardianship Caregiver
Last 4 digits of Social Security Number:
Last Name:
First Name:
Foster Care License Number:	Expiration Date:
Agency Name:
Your Home Street Address:
City:
ZIP:
What county do you live in?
Day Phone:
Evening Phone:
Email:
Check here if under the Americans with Disabilities Act (ADA) you require auxiliary aids or services.  Attach requirements to this form.
Check meals you will attend:  (Included with conference registration.)
Friday night dinner Saturday breakfast Saturday lunch Saturday night dinner/dance Sunday breakfast Sunday lunch Requesting Vegetarian Meals
Lodging Requested
DCFS Office of Training will coordinate all shared lodging for eligible participants.  All foster, adoptive, relative and guardianship caregivers are eligible for shared lodging.  Upon receipt of your confirmation letter, you MUST personally call the hotel by the deadline stated in your letter to guarantee your room reservation with a credit card, check or other means.
Lodging requested:	Yes     No
Arrival Date:
Departure Date:
I prefer to room with:	male  female Important:  A roommate will be assigned to you if one is not specified.
Workshop Selections: (Note:  Please indicate 1A, 2C, 3D, 4G, etc.)
CPR Training:	Yes     No
Workshop 1:	(ex. 1A, 1B, 1C, etc.)
Workshop 2:	(ex. 2A, 2B, 2C, etc.)
Workshop 3:	(ex. 3A, 3B, 3C, etc.)
Workshop 4:	(ex. 4A, 4B, 4C, etc.)
Workshop 5:	(ex. 5A, 5B, 5C, etc.)
Workshop 6:	(ex. 6A, 6B, 6C, etc.)
Workshop 7:	(ex. 7A, 7B, 7C, etc.)
Print a copy and return your conference registration by fax (217/557-4349) or mail (Station 122, 227 S. 7th St., Springfield, IL  62701) by October 10, 2008. Keep a copy for your records.