Second Nature Educational Consultant Workshop Registration

Southeast Region

Friday, December 9, 2011

9:oo a.m. to 4:00 p.m.
Renaissance Atlanta Midtown (formerly the Hotel Palomar)
866 W. Peachtree Street, NW
Atlanta, Georgia 30308

Name

Telephone

Will your travel require a flight?

We are happy to make all arrangements for you to attend the workshop (including lodging and travel). We’ll arrange flights to arrive in time for you attend the special Welcome Reception and Dinner. Return flight options include departure Friday evening or Saturday morning, whichever you prefer. We will contact you with flight options prior to booking to ensure flights work for you.

Departure Airport

Your Name as it appears on your I.D.

Your birth date (required to make flight reservations)

Frequent Flyer Account Name

Frequent Flyer Account Number

Any special preferences (fly home Friday evening or Saturday morning, lodging Friday and/or Saturday?):

A special Welcome Reception and Dinner will be held Thursday, December 8, beginning at 6:30 p.m.

I will attend the Welcome Reception and Dinner
I am not able to attend the Welcome Reception and Dinner

Please note any special dietary requirements for the Thursday dinner and meals during the workshop on Friday.

Comments, Questions, Requests? Please let us know! We look forward to seeing you!

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