Southern University and Agricultural and Mechanical College

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HBCU Counseling Center Conference

7th Annual Historically Black Colleges and Universities
Counseling Center Conference: Mental Health Among black College Students

 

Registration is a two-step process

    Complete the web form below 
    Submit your check or purchase order(s) (Made payable to SUBR/HBCU-MH Conference) to:
    SUBR University Counseling Center 
    P. O. Box 12874
    Baton Rouge, LA 70813
    or
    Pay by credit card, please download, complete, and fax the Credit Card Authorization Form to 225-771-3560. 

 

Your registration will not be considered complete until registration fees have been received. 

 

 

 

Conference Registration Fees
On or before October 19, 2012             After October 19, 2012
Professional $150 Professional $175
Student $25 Student $25

 

 

Name

(First Name)

(Last Name)
Title

(Director, Assistant Director, Counselor, etc.)
College/University

(full name, no acronyms)
Mailing Address
City
State
Zip Code
E-mail Address
ACCOMMODATIONS: If you require special accommodations to permit your attendance or participation, please provide your written request here: