REGISTRATION FORM
Please copy this form for multiple registrations.

1.  Your Information

2.  Registration Fees

Morning registration fee includes conference handouts, continental breakfast, lunch and all sessions through 1:45 PM. Afternoon registration fee includes conference handouts, lunch and all sessions following 12:45 PM. All-day registration fee includes conference handouts, continental breakfast, lunch and all sessions through 4:00 PM.  Advanced registration is available through October 4. 

Early reservations are recommended, as seating is limited.

3.  Choose Your Events

Morning Breakout Sessions 10:45 – 11:45 AM (select one)
__ Making the Business Case for Eldercare Services in Your Organization
__ Company/Nonprofit Organization Collaboration for Meeting Eldercare Needs
__ Long-Term Care Insurance
__ Assessing the Need for Eldercare Services in Your Organization
__ Managers as Key to Creating a Supportive Environment for Caregivers
__ Centralizing Services Requests to Maximize Employee Satisfaction

Afternoon Caregiving Workshops, First Session 1:45 – 2:45 PM (select one)
__ Long Distance Caregiving
__ Cancer Care: Medical & Non-Medical Initiatives
__ Legal Issues: Wills, Advance Directives & the Power of Attorney
__ Elder Caregiving: Creating Harmony While Helping
__ Understanding Medicare, Medicaid and Other Health Insurance
__ Caregiving In The Home

Afternoon Caregiving Workshops, Second Session 3:00 – 4:00 PM (select one)
__ Talking to Healthcare Professionals
__ CARE Delaware: Caregiver Assistance – Respite – Education
__ Financial and Estate Planning for Long-Term Care
__ Housing Options for Older Adults
__ Long-Term Care Insurance: The Truth of It All
__ Personal Safety & Scam Alert

4.  Payment Information

__ Check/Money Order (payable to: The Family & Workplace Connection, ElderCare Awareness Conference 2002)

__ Credit Card:  __ MC __ Visa  |  Exp. Date _____

5.  Substitutions, Cancellations, and Special Needs

Substitutions are permitted at any time for confirmed conference registrants. Written cancellation requests must be received by October 23, 2002.

Cancellation requests received after that date will be processed less a $30 fee. No phone cancellations, please. No refunds after October 30, 2002.

__ Special Needs:  If you have special needs that may require accommodation, please check this box and a member of our registration team will contact you to discuss your needs. 

6.  MAIL or FAX this form right away!
Take advantage of our advanced registration rates through October 4!