EVENT INFORMATION:

DATE - MONDAY, JUNE 15, 2009

TIME - 7:30 AM – 4:00 PM
LOCATION - NORTH SHORE HARBOR CENTER
100 HARBOR CENTER BLVD.
SLIDELL, LA 70461
ORGANIZATIONS THAT WANT TO PARTICIPATE IN THE EMPLOYER RECRUITING CENTER MUST COMPLETE THIS FORM.
PLEASE COMPLETE ALL REQUESTED ORGANIZATION INFORMATION, INCLUDING THE NAME, PHONE, AND E-MAIL ADDRESS
OF THE CONTACT PERSON.
REGISTRATION FEE: $250.00 – INCLUDES A TABLE, TWO CHAIRS, AND ENROLLMENT OF TWO EMPLOYEES FOR THE
SEMINAR. IF AN ELECTRICAL CONNECTION IS REQUIRED FOR YOUR DISPLAY, BE SURE TO MARK THE BOX BELOW
REQUESTING THE CONNECTION. IF THE BOX IS NOT MARKED, IT WILL NOT BE POSSIBLE TO PROVIDE AN ELECTIRCAL
CONNECTION. THERE IS A $50 CHARGE FOR THE ELECTRICAL CONNECTION.
IF YOUR ORGANIZATION ENROLLS MORE THAN FOUR PEOPLE FOR THE SEMINAR INCLUDING THE TWO FOR THE RECRUITING
DISPLAY, THERE WILL BE A STANDARD SEMINAR DISCOUNT APPLIED TO THIS FEE IN ACCORDANCE WITH THE ORGANIZATION
REGISTRATION PROCEDURE. CONTACT THE SALT COUNCIL FOR INSTRUCTIONS ON COMPLETING THIS FORM.
IT IS NOT NECESSARY THAT THE EMPLOYEE(S) WHO STAFFS THE RECRUITING TABLE ATTEND THE SEMINAR; YOU MAY
ENROLL TWO PEOPLE FOR THE SEMINAR AND STILL HAVE TWO EMPLOYEES AT THE TABLE. IF YOU CHOOSE TO HAVE
DIFFERENT PEOPLE ENROLLED, BE SURE TO FILL IN THE APPROPRIATE SPACES ON PAGE 2. LUNCH WILL BE PROVIDED FOR
EMPLOYEES AT THE TABLE IF THEY ARE NOT ENROLLED IN THE SEMINAR, HOWEVER THEY WILL NOT RECEIVE A SEMINAR
INFORMATION PACKET.
THE REGISTRATION DEADLINE IS JUNE 5, 2009.
RESERVATIONS POSTMARKED AFTER JUNE 5, 2009 WILL NOT BE HONORED, AND YOUR PAYMENT WILL BE RETURNED.
FOR FURTHER INFORMATION, CALL THE SALT COUNCIL MESSAGE CENTER AT 985-809-5450 AND LEAVE YOUR NAME AND
A CALLBACK NUMBER.

REGISTRANT INFORMATION
COMPLETE THE ORGANIZATION INFORMATION BELOW, AND LIST EMPLOYEES ON THE ATTACHED PAGE.
PLEASE PRINT

ORGANIZATION: ________________________________________________________________________________

MAILING ADDRESS: _____________________________________________________________________________

STREET OR PO BOX

_____________________________________________________ _______ __________________________

CITY STATE ZIP CODE

CONTACT NAME: _______________________________________________________________________________

CONTACT PHONE: _____________________ E-MAIL: __________________________________________________

ELECTRICAL CONNECTION REQUIRED (ADDITIONAL $50 FEE): TOTAL ENCLOSED: $_________________

Mail to:
St. Tammany SALT Council
PO Box 596
Mandeville, LA 70470-0596
ST. TAMMANY SALT COUNCIL PHONE: 985-809-5450 E-MAIL: WEAAD@STSALT.ORG
NEW 0409
REGISTRATION TYPE (MARK CORRECT BOX)
BASIC
PROFESSIONAL
NASW-LA
LDAA

REGISTRATION TYPE (MARK CORRECT BOX)

BASIC
PROFESSIONAL
NASW-LA
LDAA

ST. TAMMANY SALT COUNCIL PHONE: 985-809-5450 E-MAIL: WEAAD@STSALT.ORG

NEW 0409