9th Annual Statewide Conference Registration Form

Online registration requires payment through PayPal
If paying by check or purchase order, please print out the registration form and return via mail or fax. The conference brochure including the registration form can be found at http://www.albany.edu/autism/conferences_annual.php

Registrant Information

First Name: A value is required.

Last Name: A value is required.

School District or Agency: A value is required.


Address: A value is required.

Address Line 2 if needed:

City: A value is required.Minimum number of characters not met.

State: A value is required.

Zip Code: A value is required.

County: A value is required.

Phone Number: A value is required.

Email: A value is required.Invalid format.

Name on credit card, if different than registrant:

Breakout Session Choices: Choose one from each session

Session One

Please make a selecti

Session Two

Please make a selection.

Registration Fees

  • $65 NYS Resident
  • $90 Out of State Resident
  • $75 NYS Resident and NASP Credits
  • $100 Out of State Resident and NASP Credits