Registration Form
7th Annual NESA Conference-
San Diego, CA October 20-24, 2001
DEADLINE FOR REGISTRATION IS SEPTEMBER 30, 2001.

Registration forms received after this date will be subject to a late fee of $50.00 and will be processed on a "space-available" basis. No refunds will be issued after the date of conference. The first 100 applicants will be entitled to a Yacht trip, around scenic San Diego Bay, aboard the "Hight Spirits." Payments or purchase order must be received with completed registration form.

Name:________________________________________________________________

Organization:__________________________________________________________

Address:______________________________________________________________

City:________________________ State:______________Zip:______________

Phone:_____________________________ Fax:__________________________

EMail:___________________________________________________________


Pre-conference sessions October 20 (Choose one for each day)

_____ New Grantee Orientation $139 (9am - 3pm)

Pre-conference sessions October 21 (Choose one for each day)

_____ New Grantee Orientation (repeat) $139 (9am - 3pm)
_____ Even Start Evaluator's Institute $139 (10am - 3pm)
_____ "How to do our best in promoting positive parenting and future competency
            in young children."  Janet Dean  $99 Half Day Session (9am - Noon)

A. Total Pre-conference fees: $ ________

Conference Registration October 22 - 24 (including membership renewal) $265 ________

B. Total registration fees: $ ________

Total Due (add A & B) _______________
PO# _____________________________________________________________

(Please FAX a copy of the purchase order with this registration)


Please charge to my: ______Mastercard ______Visa

UNITED AIRLINES
IS OFFERING
A 5% DISCOUNT TO NESA
ATTENDEES...
PLEASE CALL
1-800-521-4041
AND REFERENCE OUR
MEETING TOUR
ID CODE:
5561P
CALL THEM
TO GET INFORMATION
REGARDING THIS OFFER,
AND
TRY TO BOOK 60 DAYS AHEAD
FOR AN ADDITIONAL 5%
DISCOUNT
Account Number:_____________________________Expiration Date:__________

Signature:___________________________________________________

If paying by credit card, please FAX completed registration form to NESA at (619) 297-9107. If paying by check, please make check payable to National Even Start Association and mail this application, with your check,to our new address at:

2225 Camino del Rio South, Suite A
San Diego, CA 92108


Your confirmation letter will serve as your invoice/receipt. Please call NESA at (800) 977-7777 for further information or visit our web-site at evenstart.org.


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