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LAPEN Third Annual Summit for Parent Educators

March 1, 2010

REGISTRATION FORM
Please complete the following information.

Name:

Title:

Organization:

Mailing Address:

City, State, Zip:

Telephone with Area Code:

Fax:

E-mail:

____ I will attend LAPEN’s Summit on March 1, 2010.


____ $25 check included (deadline is February 5, 2010)

Mail this registration form with $25 check payment to:


LA Partnership for Children and Families
Attn: LAPEN Summit
P.O. Box 64507
Baton Rouge, LA 70896

Deadline for registration is February 5, 2010 and includes summit fee and lunch. Mail
must be postmarked on or before February 5. After February 5 you must register onsite.
Onsite payment is $30; lunch will not be included with onsite registration.

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