Wellbriety Movement Spring Leadership Conference Registration Form
Taking a Stand against Meth: Recovery is Possible
April 20-23, 2006 Denver, CO

Click here for conference PDF flyer for more information
Click here for the Call for Presenters PDF registration form

Conference Location:
Double Tree Hotel
3203 Quebec Street
Denver, Colorado 80207
Reservations: 303.321.3333
Room Rates: $72 plus 13.85%
local taxes & fees

Registration Fees:
$225.00 per person (Early Bird)
$275.00 after March 1, 2006

There are three ways to register:
1. Online, continue below.
2. By phone at 1-877-871-1495.
3. By mail. Click here to download the conference registration form.

First Name:
Last Name:
Address:
City:
State:
Zip:
Phone:
Email:
Organization:
Age:	> under 18 > 18-25 > 26-35 > 36-50 > 51-70 > over 70
Select One:	> treatment/prevention services provider > vendor > tribal/community leader > presenter > student
Occupation:
Select One:	> Native American/Alaska Native > Asian American > African American > Caucasian > Hispanic
Tribal Affiliation:
Registration:	> $225.00 per person (Early Bird)   $275.00 after March 1, 2006
	* If you would prefer, you may call White Bison at 1-877-871-1495 to register and pay by phone.