Autism International Association
c/o MicroSpec Registration
4603 Spring Branch Ct.
Louisville, KY 40241
Or fax to: 888-780-0663
Autism One 2009
The Westin O'Hare Hotel
May 20-24, Chicago
Registrant Information (Fields marked with a *are mandatory.)
First Name *
Last Name *
Referring organization (if applicable)
Significant Other Name
First: Last:
(if registering for conference)
Title
(if appropriate)
Company
(if appropriate)
Street Address *
Address2
City *
State *
Zip Code *
Country *
Phone *
Fax
Email *
Please answer the following questions:
Mentor Program - I would like a mentor:
Yes No
Where did you hear about the Autism One conference:
Are you a :
Parent Professional
Fee Schedule (please select the following)
Pre-Conference Days (Two-day programs)
Defeat Autism Now! Clinical Training, Thursday & Friday May 21 &22
Register for the Defeat Autism Now! Clinician Training Click Here.
$695
Elizabeth Birt Center Training in Autism Law & Advocacy, Thursday & Friday May 21 & 22
(includes a 5-day pass to the conference)
$295
Special Rates
1 to 3 years out of law school
$150
Law Student
$49
Pre-Conference Days (One-day and half-day programs)
Art of Cooking Special Diets, Wednesday May 20
$69
Miracle Project Workshop, Wednesday May 20
FREE
Health & Happiness, Wednesday May 20
$69
First Responders, Thursday May 21
FREE
Special Education Law Day, Thursday May 21
$69
Beginning Biomed - In Spanish!, Thursday May 21
FREE
CARD Feeding Clinic, Thursday May 21
FREE
Beyond a GF/CF Diet, Thursday May 21
FREE
Verbal Behavior Workshop, Thursday May 21
FREE
Miracle Project Workshop, Thursday May 21
FREE
Main Conference Days - Friday, May 22 - Sunday, 24
(includes Thursday evening)
Main Conference: 3-Day Pass - includes Sharing
$249
Significant Other Option: A second 3-Day Pass for significant Other
(with Main Conference 3-day pass registration only)
$99
Main Conference and Preconference: Active military personal and family members
$49
1 Day Registrations
1-day passes are not necessary for those who purchase the Main Conference 3-day pass
One Day Registration - Friday, Saturday, and/or Sunday
$115
Special Events - Conference Dinners (Please select Number of Dinners)
#Dinners
Thursday, May 21 6:00 pm - 9:30 pm
$25
Saturday, May 23 7:30 pm
$65
Childcare (cost is per session per child)
#Children
Days Required
Morning session 7:30 am – 12:30 pm
Wed
Thu
Fri
Sat
Sun
$30
Afternoon session 12:30 pm – 5:30 pm
Wed
Thu
Fri
Sat
Sun
$30
All Day 7:30 am – 5:30 pm
Wed
Thu
Fri
Sat
Sun
$50
Please enter the names of the children:
Individual one-on-one childcare is available for $13.00 per hour. Please call 714.680.0792 to book.
Donation
Please help in our continuing fight against autism..
Become a Patron; make a difference with your donation. $25 Silver $50 Gold $100 Platinum Other Enter Amount: $
We plan to publish names of our Patrons on our website.
Check here for permission to publish your name:
Payment Information
Payment By *
Visa
MasterCard
Amex
Card Number *
(enter WITHOUT spaces)
Expiry *
(MMYY)
Cardholder *
(as it appears on card)
Refund Policy. For registration cancellations, send written notice to Autism One Registration Headquarters
(fax to 888-780-0663)
or email to autism@microspec.com (You can also mail to Autism One Conference, c/o MicroSpec Registration, 4603 Spring Branch Ct, Louisville, KY 40241-5526). For notices received prior to April 25, 2009 your registration fee will be refunded less 25% cancellation charge. No credits given for late notices or for "no shows". For questions about the conference, email Registration@autismone.org