2020 Conference Registration

When: Friday, September 18 (afternoon) and Saturday September 19 (morning)

Where: VIRTUAL

More Info: chattanoogaautismcenter.org/conference

Questions: Call 423-531-6961, opt. 2 or opt. 4 or email info@chattanoogaautismcenter.org.

Final registration deadline is September 13.

Registration is non-refundable.

Registrant Information

If registering a family or group, use the name of one registrant here (the rest can be added later).

Name

First Name

Last Name

Verify Email

Phone

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

I am...

a parent of a child with autism.

a relative of someone with autism.

an individual with autism.

a service provider.

an educator.

none of the above, I just want to learn about autism.

Registration Type

$40 - Individual

$75 - Family of 2 or more

$80 - Clinician seeking CEUs

$100 - Medical CMEs

$25 - Student

Family Members - MUST ENTER NUMBER

How many family members (not including yourself) will be attending?

Family Member #1

Full name of first additional registrant.

Family Member #2

Full name of second additional registrant.

Family Member #3

Full name of third additional registrant.

Family Member #4

Full name of fourth additional registrant.

Track Preference

You can attend any workshops at the conference, even if they aren't in your selected track. Track preferences are for planning purposes only.

Parents

Educator

Adult

Medical CMEs

Optional Donation to the Chattanooga Autism Center

$20

$50

Add 3% to my total amount to help cover the payment processing fees