Before you submit, please take a moment to fill out the College of San Mateo/South Bay Regional Training Consortium application and fax it to (714) 415-5509 or, if paying by check, send it along with your check. By doing so you will get .5 college credits for attending out seminar and it helps both CCUG and the college. To access the formclick here.
2012 CCUG Member (Dues were paid as of 6/30/12)?
The registration fee to attend the full seminar is:
Member - $350
NonMember - $450
The registration fee to attend a single day of the seminar $175 for Members or NonMembers.
I will be attending (Please select)
If you will be attending two or three days, please indicate to the right which days you will be attending. When registering for multiple days, consider registering for the full seminar for a potential savings.
REGISTRATION CUT-OFF DATE: Registration and payment must be received no later than August 24, 2012. If payment is not received by that date a $50 late fee will be added to your registration.
REFUND POLICY: All cancellation/refund requests must be received in writing prior to August 24, 2012. We are unable to provide refunds after that date. We cannot accept telephone cancellations.
ASSISTANCE AND SPECIAL NEEDS: CCUG will attempt to accommodate all attendees with special medical, religious, and dietary needs whenever possible. So that we may make the necessary arrangements, please indicate any special needs below. Menu modifications will be made for medical, religious, and reasonable dietary requests.
EMERGENCY CONTACT INFORMATION: Please complete the information below so that in the event of illness or injury a CCUG representative will be able to contact the appropriate person(s). Because you are attending on behalf of your agency and are covered individually by your/your agency's medical insurance, the following information is needed to make the necessary phone calls and report an illnesses or injuries as soon as possible.
Name
Phone #
Alt. Phone #
Relationship
PERSONAL CONTACT:
Name
Phone #
Dept/Unit
Title
AGENCY CONTACT:
PLEASE NOTE: If you want a copy of your seminar registration, please type CTRL+P or use your browser's print function prior to submitting. You will not receive a completed copy of this form after you submit. If you need to complete your registration manually and mail/fax it, click here (please do not send a printed copy of this form).
Name of submitter - if paying by credit card, please provide the name on the credit card
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