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									28th Annual Conference and Meeting San Francisco Airport Marriott

March 5 – 6, 2010

Keynote Speakers: Ellen Goldblatt and Dr. George Singer
Hotel: San Francisco Airport Marriott Address: 1800 Old Bayshore Highway, Burlingame, CA 91410 Hotel Information Room Rate: $129.00 until February 4, 2010 Reservations: (650) 692-9100 or (800) 228-9290 – be sure to mention Cal-Tash to get the conference rate!

Conference Registration Form
PLEASE COMPLETE ALL INFORMATION REQUESTED BELOW: Are you currently a member of TASH/CALTASH? Your Name Phone Number Yes___ No___ Address E-mail

 Are Sign Language interpreter services needed?


Circle the appropriate box; indicate if full day or one day only

International TASH Member Rates Full Conference Friday or Sat only Non Member Rates Full Conference Friday or Sat only

Early Bird Rate (until 1/31/2010) $175 $100 Early Bird Rate (until 1/31/2010) $220 $125 $265 $150 $220 $125

After 1/31/2010

After 1/31/2010

Person with Disability, Family Member, or Direct Assistant to Person w/Disability Full Conference $115 Friday or Saturday only $65

Teams of Five (5) 5 people registering together at the full conference rate – 6th person is free! All registrations forms must arrive together in the same envelope

DONATIONS Would you like to make a tax-deductible denotation to support a selfadvocate or a parent attend the conference? YES: $_________________

TOTAL AMOUNT DUE (check or money order only)

Conference Registration Donation Amount of Check

$___________________ $___________________ $___________________

Mailing Information

Please mail form along with your check or money/purchase order NO LATER THAN February 20th & make payable to Cal-TASH (no credit cards) to: LORI HANEY CONFERENCE REGISTRATION 6219 AVENIDA GORRION GOLETA, CA 93117

Refunds, less 25% processing fee will be made for cancellations prior to 2/11/10.

Refund Information

E-mail CAL-TASH at: Cal-TASH is vendored by the Regional Center System (DDS) of California. Call Regional Center Case Manager/Service Coordinator to request support. Our regional center vendor number is PW2184.


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