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CRIME VICTIMS' RIGHTS CONFERENCE
May 10-11, 2017
Hosted by Governor Sam Brownback and Attorney General Derek Schmidt

Preconference Institute
May 9, 2017
Hosted by the Kansas Coalition Against Sexual and Domestic Violence

Preconference Institute
May 9, 2017
Hosted by the Children’s Advocacy Centers of Kansas

Each participant from your agency must fill out this form. 

Participant Information

Please enter Name & Agency as you would like it to appear on conference materials.
* indicates a required field
Example Format: XXX-XXX-XXXX
Example Format: XXX-XXX-XXXX
Profession (please select the category that describes your position)*














If you checked Student / Other please indicate your area of study or profession.

Registration Options

PLEASE READ EACH OF THE OPTIONS BELOW AND THEN SELECT ONE

Registration and payment or purchase order must be received by April 17th to qualify for the reduced registration rate.

Option 1. KCSDV Preconference Institute Only

  • Tuesday, May 9th
  • Registration Includes:  Training, Training Materials, & Lunch

Option 2.  Children's Advocacy Centers of Kansas Preconference Institute Only

  • Tuesday, May 9th
  • Registration Includes:  Training, Training Materials, & Lunch

Option 3.  Crime Victims’ Rights Conference Only

  • Wednesday, May10th & Thursday,May 11th
  • Registration Includes:  Four general sessions, Five workshops, Two continental breakfasts, Two lunches, & Conference materials

Option 4.  KCSDV Preconference Institute & Crime Victims' Rights Conference

  • Tuesday, May 9th - Thursday,May 11th
  • Registration Includes: Training, Training Materials, & Lunch for the Preconference and Four general sessions, Five workshops, Two continental breakfasts, Two lunches, & Conference materials

Option 5.  Children's Advocacy Centers of Kansas Institute & Crime Victims' Rights Conference

  • Tuesday, May 9th - Thursday,May 11th
  • Registration Includes: Training, Training Materials, & Lunch for the Preconference and Four general sessions, Five workshops, Two continental breakfasts, Two lunches, & Conference materials
Select a choice




Workshop Preferences

To assist with conference planning, please choose your top 2 preferences for workshops. This allows us to determine the best room location for each workshop.

Refer to the workshop descriptions on the conference home page.

If you are attending the Preconference only, please select the Preconference option.

Session I - May 10th Morning Session

First Preference








Second Preference








Session II - May 10th Afternoon Session

First Preference








Second Preference








Session III - May 11th Morning Session

First Preference








Second Preference








Session IV - May 11th Afternoon Session

First Preference








Second Preference








Session V - May 11th Afternoon Session

First Preference







Second Preference







Payment Information

Payment(s) will be made via:



Do not under any circumstances put the credit card number in the space below.
The
link to the secure payment page will follow after you submit your registration.
NOTE: ALL individuals must complete this registration form before they will be registered in the conference.

Make checks payable to the Office of the Governor, referring to the Crime Victims’ Rights Conference in the memo.  Tax ID for payment is 48-6029925.

Mail payment to:
900 SW Jackson Ave. 
Landon State Office Building, Room 304 N
Topeka, Kansas 66612

Purchase Orders:  Email a copy of form to Shawn Cowing

Before submitting this form: If your agency requires an invoice to issue payment, please print this page to serve as your invoice.

 

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