Please fill out the form below, selecting your preferences for the conference.

The Conference will be Red Lion Inn - Jantzen Beach
 

When finished, click the "submit" button at the bottom of the page. 

Once "submitted", your information will be forwarded:
 to Fawnda Veysey at OSP Forensics Division.

1.)  Registrant Information: Please provide the requested information below:

Discipline Type

Police

Treatment Provider  

Judicial 

Speaker/Presenter

Other (Specify)

First Name:

Last Name:

Organization:

Address:

Phone:

Email Address:

2.) Registration Fees/ Meal Information:

Registration Fees:

$150.00 - Registration fee for both days,  April 17th and April 18th  (Includes lunch and materials)
 

$80.00 - Registration fee for one day, either April 17th OR April 18th (Includes lunch and materials)

**Note:  Your check/money order must me made payable to "DUII Multi-Disciplinary Training Task Force" or it will be returned to you.   See below for address to send check.

 

c/o Fawnda Veysey
OSP Forensic Services Div.
13309 SE 84^th Ave
Clackamas, OR  97015

Registration Fee Paid 

(Covers Registrants Meals and Materials):
 

Please select an available option>>> $150.00 (Full Registration) $80.00 (April 17th Only) $80.00 (April 18th Only) Approved for Registration Scholarship

***If receiving scholarship to attend, please indicate which organization has approved your scholarship in the notes section below.

Meal Selected-Friday 

  Lunch on Friday - April 17th, 2009

Meal Selected-Saturday 

  Lunch Saturday - April 18th, 2009 

Special Notes Section: Add any pertinent notes (i.e. dietary meal restrictions) 

Special Notes:   

Add Any Special Needs Here...

The Oregon Department of Transportation is committed to accessibility. Materials on this Web page that do not meet the accessibility standards defined by the World Wide Web Consortium (W3C), Web Content Accessibility Guidelines 1.0, Conformance Level "A" are available in alternate formats upon request.
Please e-mail Steve Vitolo.