"Standing Up To Bullying" Conference Pre-Registration Form

Pre-Registration Form Instructions

Please complete and submit this pre-registration form before the deadline date of the conference you wish to attend.
The cost per participant to attend this 3-hour conference onsite is $35.00 and $25.00 to attend the webinar. All major credit/debit cards and personal/business checks are accepted. School purchase orders are also accepted. For a limited time, each educator and student of those schools or districts that pre-register 15 or more participants to the conference will receive a free copy of our ‘Standing Up To Bullying’ game along with free unlimited game updates and upgrades. In addition, these schools or districts will receive a $5.00 discount per participant.
If you need to cancel your reservation and would like a refund, you must email Building Strong Families National Seminars at Cancellation@StrongFamilies.us or phone us toll-free at 1(866)544-4075 seven days before the conference date and you will be granted a refund. Because PayPal charges us a $.30 processing fee per transaction, this amount will be deducted from your refund for all online payments.
After submitting this pre-registration form, you will immediately receive a confirmation email detailing important information such as the conference location that you registered for, the conference date/time, and the link to the conference outline. If you do not immediately receive this email, please email us at Info@StrongFamilies.us or phone us toll free at (866) 544-4075.
The outline is made available in PDF format. Please download and print the outline and bring it with you to the conference (optional). If you do not already have PDF installed on your computer, please click the following button to download this free reader:

Pre-Registration Form

Which conference would you like to pre-register for? (required)

(*For your convenience, the conference/webinar times are automatically converted to your time zone)

N/A

What is your name? (required)

What is your email address? (required)

What is your telephone number? (required)

Who are you pre-registering? (required)

Just myself.
Myself and others.
Others and not myself.

If you are pre-registering others, please enter their names, email addresses, and telephone numbers in the boxes below. Please enter the information one name per line:

Names:
Enter Names Here Emails:
Enter Emails Here Telephone numbers:
Enter Telephone Numbers Here

(Optional) To customize and maximize your conference experience, please list in the box below the conference topic(s) that you would like highlighted and/or request a topic(s) that is/are related to youth bullying and school violence that you would like discussed during the conference. Your request will be considered:

Discounted fee:

Check this box if you are pre-registering as part of a group of 15 or more from a school district to receive your 14% discount ($30.00 per participant).

If you are pre-registering as part of a group, please type the name of the school district you are from:

I wish to pay: (required)

Online prior to the deadline date.
By mailing a check to be received prior to the deadline date.
With a school purchase order. My district will pay online prior to the deadline date.
With a school purchase order. My district will mail a check.
With a school purchase order. I will bring a check to the conference.

*Checks must be payable to Building Strong Families National Seminars and mailed to:

Building Strong Families National Seminars
PO Box 1295
El Mirage, AZ 85335-1295

***Please make sure that the check includes the names of the individual(s) whom the payment covers.

If you already have a school purchase order number, please enter it here:

Please feel free to email your purchase order to Info@StrongFamilies.us.

If other than the submitter, please type the name of the business we should bill, i.e. school district, company, etc:

If other than the submitter, please type the name, email address, and phone number of the one we should email the invoice to:

How did you hear about this conference?

Additional comments:

Upon receipt of your pre-registration form, an invoice will be prepared and emailed to you (To keep the conference fee low, we only email invoices/receipts).