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Registration Form
CONFRONTING FAMILY AND COMMUNITY VIOLENCE – The Intersection of Law and Psychology
May 1 - 3, 2014

American Psychological Association and the American Bar Association
National Conference
Washington, DC

Print Out Registration Form and Pay By Check (PDF).
* indicates required fields.
*First Name:
Middle Initial:
*Last Name:
*Address 1:
Address 2:
*Zip/Postal Code:
*Please check appropriate membership category and add membership # if applicable.
ABA Member #
APA Member #
Other Affiliation or Profession
How did you hear about this conference?

*Registration Fees

Standard Registration (after March 31, 2014)
$375 APA and ABA Members
$425 Non-APA and Non-ABA Members
$300 Special Reduced Registration fee for Government Employees
$250 Full-time Students Only (limited number only)
$175 Guest Fee - Guest of (conference materials not included and guests are not entitled to attend continuing education conference sessions or secure CE or CLE credit)

We encourage participation by all individuals. If you are a person with a disability, giving us advance notification of any special needs will help us to accommodate you better. If you have any special needs please provide details .

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Telephone: 800-374-2721; 202-336-5500. TDD/TTY: 202-336-6123
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