PS. Please send names and address of any Teen Courts you may know about.

FEEL FREE TO DUPLICATE AND DISTRIBUTE AS APPROPRIATE

**ADDITIONAL REGISTRATION INFORMATION**

Training School Conference Limited to 100 Adults Only

YES, I AM DEFINITELY COMING TO

___ 4 - Day New Comer ___ 2 - Day Old Timer

The Teen Court Training School Dates of ______________

One Registration Form for each Individual

(PLEASE PRINT AND CHECK APPROPRIATE BLANKS)

I am registering ___ only myself __ myself and associates

Name __________________________________ Driver's License # ________________________

Address_____________________________________ City/State/Zip ______________________________

Phone(s) ___________________________________ Fax ______________________________ E-MAIL __________________________

Title/Occupation _______________________________________________

Home Phone(s) __________________________________ Sex: ___ M ___ F

***Important: I (We) will arrive by ___ car ___ plane ___ train

There ___is ___is not a Teen Court Program in my area.

___ CALL ME NOW, I need information on starting a Teen Court Program immediately in my area

I am attending the Conference for the purpose of learning:

___ how to establish a new District Teen Court Program in my area or

___ how to improve the Teen Court Program in my area by Affiliation or

___ how to affiliate my court with a District Teen Court program

___ how to affiliate my school district with a District Teen Court Program

___ how to affiliate my military installation with a District Teen Court Program.

FULL REGISTRATION FEES ARE DUE FOR ATTENDEES

___ My ___ $350 ___$175 Registration fee is enclosed before the registration deadline.

___ My Registration fee of $_____ is enclosed with the Registration fee(s) of ______________________

___________________________ as there are ______ members in our group.

___ My Full Registration fee of $_____ is enclosed I am also enclosing the $ ______ in additinal fees for ___ Associates for a total of $ _______>