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SWORTC Conference Template

Please Fill Out Completely

Each person attending needs to complete a registration form. If you are part of a couple, we need a completed registration form for each of you. Thanks.
9. Licensing Agency Type *This question is required.
13. Saturday Morning Session (9:00 am to 12:00 pm) - choose one
14. Saturday Afternoon Session (1:00 pm to 4:00 pm) - choose one
15. Friday Meals (Select all you plan to attend)
16. Saturday Meals (Select all you plan to attend)
17. Complimentary Lodging Request:
Complimentary lodging requires being a caregiver licensed by a county agency AND living 50 miles or more from Holiday Inn Eastgate AND attendance during the entire conference.