National Domestic Violence Hotline - 1-800-799-SAFE (7233) or (TTY) 1-800-787-3324
Report Child Abuse - It's the Law - 1-800-252-5400

Resources

Calendar
Conference
Registration

Registration Form

Last Name First Name MI

Address City State

Day Time Phone

Employer E - Mail

Discipline (Please check all that apply)

Social Work	Education	Psychology	Nursing
Legal	Investigation	Probation	Physician
CCCFV member	Other

Continuing Education Credits (Please check all that apply)

LPC	LMSW	LCSW	LCDC	LMFT	CJAD
RN	LPN	TCLEOSE	PhD. Psychology
Other

Registration Fees and Deadlines

Early Bird: Must be received by 10/07/2009 $120.00

the Door: $150.00

Payment Options

Check (Please include participant’s name on check) Check Number
Credit Card

Checks: Pay to the Order of: JUNIOR LEAGUE OF PLANO
Mail checks and/or purchase orders to:
Collin County Council on Family Violence (CCCFV)
C/O Junior League of Plano
5805 Coit Road #301
Plano, TX 75093

To register online and pay by credit card, please visit www.ccc-fv.org

* For more information, please email conference@cccfv.org
*If you require special assistance, please email conference@cccfv.org or call 972-769-1142 so that we can make provisions.

How did you learn about this conference?

Email Brochure

Brochure in Mail

Friend/Co-worker

CCCFV Website

Other