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Registration Grant Application

Funding Your Trip to Washington

Working 2 Walk 2008 Registration

A limited number of grants are available to cover the registration fee of $150.  If you would like to apply 
for one of the grants, please click on the Grant Application link above and submit by March 15.  Awards
will be announced by March 22.

A separate registration must be completed for each individual; we apologize for any inconvenience.  Registration Fees help to defray the costs of venue rental, meals, and printed materials.  Paid Registration must be received by March 28, 2008, to ensure your space at Working 2 Walk.  The registration fee is $150 (Note: We cannot offer one-day registrations) and includes the following:

Sunday April 13:          Continental Breakfast, Seated Lunch, Evening Reception
                                                Admission to all general sessions and breakout sessions of choice

Monday, April 14:         Continental Breakfast, Box Lunch, Kickoff to Capitol Hill Banquet
                                                
Admission to all general sessions

Souvenir T- Shirt  (included in Registration - Indicate Style & Size at bottom of page)

Tuesday, April 15 is Capitol Hill Day, and all meals are on your own

To begin the Registration process, please complete the following information (* = required field).  This information will not be shared with any other organizations.  It will be used in planning for room layout, meals, printed materials, transportation and communications to ensure an enjoyable, well-organized event for all participants.  Note that you must indicate whether you wish to attend the Yoga Workshop.  There is no additional charge for the Workshop, but only registered attendees will be admitted.

Once you have completed the Registration Form you will have an opportunity to pay your fee via PayPal.  You do not need a PayPal account to use this service.  If you prefer to print the Registration Form and pay by cheque, download the form here: Print Registration Form

First Name *    Last Name *
Address 1 *
Address 2   
City *             State *    Zip  * 
Country (if not USA)              Phone 
Organization  
EMail  *       

I will attend the following days (check appropriate boxes):       April 13       April 14       

Sunday, April 13 Breakout SessionsA total of 7 different presentations will be offered; you will be able to attend 4.  Please number each box to indicate your choices in order of preference (please indicate 1 through 7).  You will receive your schedule for the day when you arrive, and we will do our best to accommodate all requests.  

For more information on these presentations, follow our Speakers & Schedule links. 

     Drs. Simon Archibald & Stephen Davies
     Dr. D. Michele Basso
     Dr. Hans Keirstead
     Dr. John McDonald
     Dr. Damien Pearse
     Dr. Yang (Ted) D. Teng
     Dr. Wise Young
    

Monday, April 14 - please check the appropriate boxes:

     I will attend the Yoga Workshop with Jo Zukovich (registration required).  More Info
              I prefer to work on the   Floor       Chair

     I will attend the Kickoff to Capitol Hill Banquet

For those who are not paid registrants, additional Banquet tickets can be purchased for $40.  You can order additional tickets in the Payment section.

Please check the appropriate box below:

   Manual Chair User             Power Chair User              Able Bodied 

If you require a Personal Assistant in order to attend W2W, his/her registration fee will be waived.  However, we ask that they complete the registration information.  Please indicate your Assistant’s name here:   

How did you hear about the Working 2 Walk Symposium & Rally?
                

Please indicate one t-shirt style & size - we can only guarantee sizes for shirts ordered by March 15!

Women's      Small        Medium       Large       X-Large

Men's           Medium    Large          X-Large   XX-Large

Please indicate method of payment:

    Check        PayPal       Speaker       Exhibitor       Grant/Comp


Please review your registration form for accuracy before hitting the "Submit" button.  Once your information is submitted you will be taken to our payment page for instructions on using Pay Pal or paying by check.  Thank you.