Alabama Association for Behavior Analysis

Enhancing Behavior Analysis through research, education, and practice

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May 23, 2013

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Convention Registration

Convention Registration Form

Please complete the following information to register for the Pre-Convention workshop(s) on October 3rd, and/or the two-day Convention on October 4th and 5th. You may pay via PayPal after submitting this information. If you prefer to mail in your convention registration form along with your payment, you will need to download and complete our paper form.

Name*
FirstLast
Address*
Street AddressAddress Line 2CityStateZIP Code
Email*
Workshop Registration
Workshops will be held on Wednesday, October 3. Conference Registration is NOT required to attend workshops.
- Workshop 1: Understanding & Treating Sleep Problems of Children with Autism and Related Disabilities - Dr. Hanley
- Workshop 2: Maximizing the Effects of Feedback on Staff Performance - Dr. Reed
9:00 to noon: 3-hour workshop Dr. Hanley*
- None (Dr. Hanley)
- Member - Includes free CEs! ($100) (Dr. Hanley)
- Student Member ($40) (Dr. Hanley)
- Non-member ($175) (Dr. Hanley)
1:30pm - 4:30pm: 3-hour workshop Dr. DiGennaro Reed*
- None (Dr. Reed)
- Member - Includes free CEs! ($100) (Dr. Reed)
- Student Member ($40) (Dr. Reed)
- Non-member ($175) (Dr. Reed)
Boxed Lunch ($23)*
- Yes
- No
Convention Registration
Convention sessions will be held on Thursday, October 4 - Friday, October 5. Please indicate your selection below. * Full members must have active 2012-2013 membership by the start of the convention. ** Students MUST provide documentation from Major Professor that they are currently enrolled as a student at a College/University for Fall 2012 in order to receive the discount.
Registration
- None
- Members - Thursday ($75)
- Members - Friday ($75)
- Members - Both days ($100)
- Student Members (Graduate) - Thursday ($40)
- Student Members (Graduate) - Friday ($40)
- Student Members (Graduate) - Both days ($50)
- Student Members (Undergraduate) - Thursday ($5)**
- Student Members (Undergraduate) - Friday ($5)**
- Student Members (Undergraduate) - Both days ($10)**
- Non-members - Thursday ($125)
- Non-members - Friday ($125)
- Non-members - Both days ($175)
**NOTE: If you are an undergraduate and you register for the convention, you are required to sign up for the Undergraduate Student membership ($15) below.
Would you like to sign up for a 2012-2013 ALABA Membership*
- Yes
- No
ALABA Membership Application for 2012-2013
Become a member of ALABA or renew your membership online! (You may also print out the membership form (link forthcoming) and mail it to us at PO Box 2337, Auburn, AL 36830.) There are many benefits to membership in ALABA! You will belong to the largest network of behavior analysts in the state, you will be updated with new and important information for behavior analysts in Alabama and you receive registration discounts to the ALABA and ABAI annual conventions!

In order to benefit from discounted convention and workshop rates complete the 2012-2013 ALABA membership online form below. Note: If you are a student member, you must provide documentation from your current institution to be eligible for the discounted student rate. We accept all credit cards via paypal. You will receive a receipt from paypal. Please hold onto your confirmation of membership!

After completing your membership, please register for the convention! Early bird rates end on September 20, 2012!

Membership begins on October 1, 2012 and ends September 30, 2013.

We already have your name and address from above, we just need the information below to complete your membership application.
Degree*
(list highest degree held)
Year*
(4 digit year, i.e. 1979)
Conferring Institution*
Licensure/Certification*
(list and provide number)
Current Profession
- Administrator
- Academic
- Third Choice
- Paraprofessional Staﬀ
- Social Worker
- Family Member
- Psychologist/Counselor
- Consultant
- Educator
- Speech Pathologist
- Behavior Analyst
- Other
Other Profession*
Areas of Interest in Behavior Analysis
- Autism Spectrum Disorders
- Intellectual Disabilities
- Learning Disabilities
- Severe Behavior Problems
- Feeding Difficulties
- Developmental Disabilities
- Policy and Advocacy Issues
- Parent Training
- Staff Training
- Research
- Functional Analysis (FBA)
- Behavior Analysis in Schools
- Other
Other Interests in Behavior Analysis*
Other Organizations in which you are a member
- American Psychological Association (APA)
- Association for Behavior Analysis, International (ABAI)
- Association of Professional Behavior Analysts (APBA)
- Other
Other Organizations*
Membership Dues*
- Full Members - PhD/EdD ($50)
- Full Members - MA/MS ($35)
- Full Members - BA/BS ($25)
- Student Member - Graduate ($15)
- Student Member - Undergrad ($15)
- Affiliate Member - Family member of an individual who receives ABA services($15)
- Affiliate Member - Direct Care professional who does not hold a BA/BS degree ($15)
- Sustaining Members ($100.00)
Please place a check (✓) in the box provided beside the membership category to which you are applying.
Total
$0.00

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