Leadership Education Conference Registration

The power of we
Registration deadline is January 15, 2011.

March 11-12, 2011
Los Angeles Airport Marriott
5855 West Century Boulevard
Los Angeles, CA 90045


Registration Fees

$395 CDA Member and Component Executive Director
$695 Non-member
$100 Late Registration Fee (Added to registration fees noted above if received after Jan. 15, 2011)
These rates also apply to spouses/guests of the specific categories.


Please complete all sections below, and then click the "SIGN UP" button.

Component Contact Information
First Name
Last Name
E-mail
Component
Phone
Fax

Attendee Information

*CDA is pleased to extend our special hotel room rate ($119 plus tax) to Leadership Education Conference attendees for Saturday evening. If you would like to extend your stay at your own expense, please indicate this below. If you wish to share a room with another attendee please identify that person in the Special Requests field.

Attendee Name (including spouse or guests) Leadership Title (Indicate Spouse or Guest if not a member of CDA Leadership) Days at LEC Vege-tarian? Hotel Check-In /Check-Out Day * Special Requests (King, Two Beds, Smoking, Marriott #, etc.)

First:

Last:

Fri
Sat		 Yes
No

In:

Out:

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Last:

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Sat 		Yes
No

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Out:

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Last:

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Sat		 Yes
No

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Out:

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Sat		 Yes
No

In:

Out:

First:

Last:

  Fri
Sat 		Yes
No

In:

Out:

First:

Last:

Fri
Sat		 Yes
No

In:

Out:


Breakout Selections

Please select your prefered breakout track below, or choose your first and second preferences if you wish to choose a-la-carte registration instead. (Refer to the conference brochure and use the corresponding track number for each session.) Should a track or workshop be full at the time your registration is processed, we will try to accommodate your selections in a different order.

Attendee Name

Register me in Track

OR

Session I:
Friday

11:30 am - 1 pm

Session II:
Friday

2:15 - 3:45 pm

Session III:
Saturday

8:45 - 10:45 am

Session IV:
Saturday

11:00 am - 1 pm

First:

Last:

 

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Second Choice

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Last:

 

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Last:

 

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Last:

 

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Last:

 

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Second Choice


Flight Reservations

Flight reservations will be booked in and out of Los Angeles according to hotel check-in and check-out dates, as well as the conference schedule. Schedules are subject to airline change. Departures on Friday, March 11 will be scheduled between 7:00 a.m. and 8:30 a.m.; return flights on Saturday, March 12 will be scheduled between 5:45 p.m. and 8:00 p.m., depending on airport (exceptions will apply). Please note your preferred departure city/airport below.

Attendee Name

(AS SHOWN ON
PHOTO ID*)

Date of Birth

(AS SHOWN ON PHOTO ID*)

Preferred Departure
City/Airport

Southwest Rapid Rewards Number

United Mileage Plus Number

First:
M:
Last:

First:
M:
Last:

First:
M:
Last:

First:
M:
Last:

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* Federal regulations require that ticket information exactly matches the information on the traveler’s photo ID. If you wish for CDA to make travel arrangements for accompanying guests, please contact Sandy Frank at sandy.frank@cda.org.


Payment Information (mandatory)

CDA Member, Component Executive Director & Spouse/Guest Registration Fee: $395
Non-member & Spouse/Guest Registration Fee: $695

@ $395 + @ $695 = Total registration amount due: $

SECURE ONLINE PAYMENT:
Complete your credit card information and click "SIGN UP." This will authorize CDA to charge your credit card account for the ammount shown above and to use this card to place a hold on any required hotel rooms and flight arrangements not otherwise covered by CDA.
Credit Card Type
Name on Credit Card
Credit Card Number
Credit Card Expires (MO/YR)