Conference F2021

Fall 2021 Directors Conference Registration

Only OCCDHE members may attend conferences. Please note your status below:
- I hold an active membership in OCCDHE
- I have submitted an application for membership in OCCDHE
Name*
First Last
License Type*
- LPC
- LCSW
- LMFT
- Psychologist
- Psychiatrist
License Number*
Position Title*
Center/Department*
Institution*
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Fax
Conference Registration & Meals*
Registration fee includes: Conference expenses, Wednesday's welcome reception and dinner, Thursday's breakfast, break and lunch, Friday's breakfast and break.
Total
$0.00
Overall Eating Preference*
Wednesday Dinner Special Request*
Dinner for Omnivores on Wednesday night will have two options: fish or chicken. Please indicate your request in the drop-down menu below:
If you register for the conference and cannot attend, you may request a refund in writing from the OCCDHE Treasurer before September 24, 2021. There will be a $25 cancellation fee. No refunds will be granted for cancellations made after September 24 2021 -- NO EXCEPTIONS. Email: ssalem@msmu.edu
Please select your Payment Type below.
Payment Type*
If paying by Credit Card, the payment screen will appear after submitting your registration form. You do not need a PayPal account. Once you are in the PayPal checkout area scroll down past the log-in prompt and click on "Pay With Debit or Credit Card" then enter the required information to use the credit card of your choice. PLEASE NOTE - PayPal security features require that the information entered for whatever credit card you are using (name on account, billing address, zip code, etc.) match exactly what is printed on your credit card statement. For example, if your statement reads: University of CA Santa Cruz, but you type in: UC Santa Cruz, the system will not accept your payment.
If paying by check, MAKE YOUR CHECK PAYABLE to OCCDHE and mail it to:

Dr. Susan Salem, OCCDHE Treasurer
Counseling and Psychological Services
Mt. Saint Mary's University
12001 Chalon Road, Los Angeles, CA 90049
If you would like to stay at the conference hotel, The Cliffs, you must book your hotel separately by calling 800.826.7827 or booking online at https://cliffshotelandspa.com/. When registering online, enter registration code: 156603.

Save and Continue Later