MOTA Conference Registration Form

Conference will be held October 24 & 25, 2008 at Maryville University in St. Louis.
Download a registration form.

Name as it will appear on badge:

Home Address:

Home Address con'd:

City, State Zip:

Home Phone:

Business Phone:

Email:

Employed By/ or OT School:

OTA

Student

I will attend:

Full Conference

Fri.

Sat.

Prefer a Vegetarian meal:

Yes

Other:

Please check the sessions you wish to attend:

Friday:

9:00 am - 9:50 am		Session 1, Management of Stroke
9:00 am - 11:50 am		Session 2, Balance Assessment
9:00 am - 10:50 am		Session 3, Social Skills Training
10:00 am - 10:50 am		Session 4, ALS
10:00 am - 11:50 am		Session 5, Horticultural Therapy Session 6, Autism
1:00 pm - 5:00 pm		Session 7, Dementia Session 8, Rural Solutions
1:00 pm - 2:15 pm		Session 9, Aging Successfully
2:25 pm - 3:35 pm		Session 10, Constraint-Induced
3:45 pm - 4:5 pm		Session 11, Carfit Program

Saturday:

8:00 am - 8:50 am		Business/Members Meeting
9:00 am - 10:30 am		Session 12, Adoption Session 13, Ergonomics
9:00 am - 12:00 pm		Session 14, Hand & UE I
10:40 am - 12:00 pm		Session 15, Ergonomic Solutions Session 16, Self Disclosure
2:10 pm - 4:00 pm		Session 17, Splints Session 18, Kinesio Taping
2:10 pm - 5:00 pm		Session 19, Hand & UE II Session 20, Saebo Orthosis
4:10 pm - 5:00 pm		Session 21, Median Nerve Stem

Full Conference Registration Fee:
If Postmarked by:	Oct. 10	After Oct. 10
OTR Member	$125	$145
OTR Non-Member	$150	$170
OTA Member	$85	$105
OTA Non-Member	$100	$120
OT Student Member	$55	$75
OT Student Non-Member	$75	$95
Member of Other State Association	$125	$145

One Day Registration Fee::
If Postmarked by:	Oct. 10	After Oct. 10
OTR Member	$75	$95
OTR Non-Member	$95	$115
OTA Member	$55	$75
OTA Non-Member	$75	$95
OT Student Member	$40	$55
OT Student Non-Member	$55	$70
Member of Other State Association	$75	$95

Subtotal:

Vendor discount: (-$50)

Committee or Speaker discount: (-$50)

MOTA Board / Committee Discount: (-$25)

Your Total:

Remember your total. After you click the button below you will be sent to a page which will let you make a payment for your registration.