Registration SSAS Tuition Registration includes FOCUS DAY 18 programming, two 3-day courses, three & learn’ events, and ‘lunch three afternoon lectures. [CE hours: ~35] Lunch will be served each day. A professional networking picnic dinner is included on Sunday night. Parking is free for all registrants. Tuitiom: $750 | Rutgers & Military: $525 and a Movie 2 CE Hours” with Dr. Anthony Tobia “Pizza – We are hosting a 2 CE and A Movie” event on Tuesday night (6 8 pm). “Dinner – Pizza and Movie: $20 Focus DAY 18 Only: Includes 5 CE hours. 1-day registration: $100 Binder In an effort to be eco-friendlier, we will have all documents available on our App Whova, which you can – download for free. Alternatively, if you would like a binder with copies of all materials, there is a $25.00 fee. Binder optional*: $25 – Accommodations I request the following accommodations: Dietary preferences/restrictions: Wheelchair Accessibility Vegetarian Other *All Summer School applications must include a payment* Payment Information Summer School 2018 Amount: $ Pizza and a Movie (Optional) Amount: $20.00 FOCUS DAY 18 Only Amount: $ BINDER (Optional) Amount: $25.00 Enclosed is my check for $_______ drawn on a US bank, made payable to Rutgers, The State University of NJ Please charge my MasterCard/Visa account for the amount of $_______ I am paying with a purchase order (PO#_________________) Cardholder’s Name Card Number CVV (# on the back Exp Date Signature Zip Code CONTACT US WITH QUESTIONS AT 848-445-4317 or Only complete, typed applications will be accepted. MAIL: Addiction Education, Center of Alcohol Studies, 607 Allison Road, Piscataway, NJ FAX: 732-445-3500 REGISTER ONLINE: alcoholstudies.rutgers.edu/ssas
Registration SSAS Tuition Registration includes FOCUS DAY 18 programming, two 3-day courses, three ‘lunch & learn’ events, and three afternoon lectures. [CE hours: ~35] Lunch will be served each day. A professional networking picnic dinner is included on Sunday night. Parking is free for all registrants. Tuitiom: $750 | Rutgers & Military: $525 “Pizza and a Movie – 2 CE Hours” with Dr. Anthony Tobia We are hosting a 2 CE “Dinner and A Movie” event on Tuesday night (6 – 8 pm). Pizza and Movie: $20 Focus DAY 18 Only: Includes 5 CE hours. 1-day registration: $100 Binder In an effort to be eco-friendlier, we will have all documents available on our App – Whova, which you can download for free. Alternatively, if you would like a binder with copies of all materials, there is a $25.00 fee. Binder – optional*: $25 Accommodations I request the following accommodations: Wheelchair Accessibility Other Dietary preferences/restrictions: Vegetarian Payment Information *All Summer School applications must include a payment* Summer School 2018 Amount: $ Pizza and a Movie (Optional) Amount: $20.00 FOCUS DAY 18 Only Amount: $ BINDER (Optional) Amount: $25.00 Enclosed is my check for $_______ drawn on a US bank, made payable to Rutgers, The State University of NJ Please charge my MasterCard/Visa account for the amount of $_______ I am paying with a purchase order (PO#_________________) Cardholder’s Name Card Number CVV (# on the back Exp Date Signature Zip Code CONTACT US WITH QUESTIONS AT 848-445-4317 or Only complete, typed applications will be accepted. MAIL: Addiction Education, Center of Alcohol Studies, 607 Allison Road, Piscataway, NJ FAX: 732-445-3500 REGISTER ONLINE: alcoholstudies.rutgers.edu/ssas
SSAS18%20Registration%20Application.docx