2019 Symposium Registration
37th Annual Midwest Symposium for Leadership in Behavior Disorders
February 21 - 23, 2019
Individuals or groups, use this form to register and pay with a credit card.
- This link will redirect to the online registration form powered by eShow.
- Each individual or group registration will require you to enter the contact information for the individual responsible for payment.
Use this form to register by mail with check payment or register groups of 10 or more securing payment with a purchase order.
- Please include name, phone number and email of the individual coordinating payment.
- Registration will be accepted by mail with check payment.
- NO Purchase Orders will be accepted for groups less than 10. Purchase orders will not be accepted by any group after the early registration deadline. Payment terms, 30 days, all payments for purchase orders must be received before or at the time of check-in at the 2019 Symposium.
- Phone: 402-792-3057, Fax: 402-875-6545, email: email@example.com, or mail: Midwest Symposium, PO Box 202, Hickman, NE 68372
|Choose one of the Following Registration Options||*Discount for Early Registration||Regular Registration|
|Presymposium Workshop & Symposium||$180.00||$205.00|
|Presymposium Workshops Only||$150.00||$175.00|
*Early Registration Discount Wednesday, January 23, 2019
Hotel Reservations are the responsibility of the participant.
If you must cancel your registration, please notify the MSLBD Office at firstname.lastname@example.org, in writing by 5:00 p.m. central time Wednesday, January 23, 2019, to receive a refund less a $35 administrative fee. No refunds will be given after January 23.
Transfer a Registration
Registrations may be transferred to another individual without penalty. Please notify the MSLBD Office at email@example.com in writing as soon as possible about the change. Please fill out a new registration form (download here) for the individual assuming the registration and list the name of the individual who will not be attending on the form.