Autreat 2007

Fees and Registration form

( A SAMPLE ONLY! )

  Days Attending: ALL Monday Tuesday Wednesday Thursday Friday
 
  Days Attending: ALL Monday Tuesday Wednesday Thursday Friday
 
  Days Attending: ALL Monday Tuesday Wednesday Thursday Friday
 
  Days Attending: ALL Monday Tuesday Wednesday Thursday Friday
 
  Days Attending: ALL Monday Tuesday Wednesday Thursday Friday

(Please list names and details of all family members who will attend)

Address:
City / State / Zip:
Phone(day):
Phone (night):
Email:

Refrigerator in room (additional $10 per day).
Private room (additional $23 per night)(*).

ANI member household?
(If one person in the household is an ANI member, then everyone in the household is eligible for the ANI member rate.)
Check here If no, and you would like to join
Add $15 (for residents of North America) or $20 (for all other countries) to total.
OPTIONAL additional donation:
Donations will be used for scholarships and overall program enhancements.

Total enclosed:

If alternate materials format is needed, please indicate:
Braille      Large print      Tape      Disk     

If accessible lodging is needed, please indicate:
Wheelchair-accessible room      Roll-in Shower      Can walk but have trouble with stairs     

Note: If you minimize margins on most A4 printers, the form itsef should print on a single page (with the rest of this page on 2 more pages).

Please remit payment, in U.S. dollars, to:
Autism Network International
P.O. Box 35448
Syracuse, NY 13235-5448

REGISTRATION MUST BE RECEIVED BY JUNE 15, 2007

Registration Fees

The sums below are in US dollars.

EARLY REGISTRATION DISCOUNT
RATES BEFORE JUNE 1, 2007

Fee Category  Member  Nonmember
Per day or 4 days totalPer day or 4 days total
A Adults with full-time jobs(1)100375107395
B Children 12 and under(2)6524070260
C Teens 13-17(2)8532090340
D Adults without full-time jobs8532090340
E Adults living on disability or public assistance5520060220
F Full-time support people(3)5018055200
RATES AFTER JUNE 1, 2007

Fee Category  Member  Nonmember
Per day or 4 days totalPer day or 4 days total
A Adults with full-time jobs(1)103385110405
B Children 12 and under(2)6825073270
C Teens 13-17(2)8832093350
D Adults without full-time jobs8832093350
E Adults living on disability or public assistance5821063230
F Full-time support people(3)5319058210

Note 1: We realize that not all full-time jobs are high paying. If you have a full-time job but can't afford this rate, add a note explaining this, and you may register at the rate for adults without full-time jobs.

Note 2: The rate for children and teens includes a supervised activity program for children under 18. Staff:child ratio is approximately 1:6. If your child needs more support than this, please bring an aide for your child, or contact ANI about hiring extra staff for an additional fee.

Note 3: This rate is for people who are attending Autreat for the purpose of providing support for a disabled person who could not participate without a FULL-TIME helper. Examples are personal care attendants for adults and 1:1 aides for children.

Work Shift Rebate

Adults and teens paying for the full 4 days, meals, and overnights may earn a $20 work rebate. Pay the full cost when registering. The rebate will be given upon completion of a work shift during Autreat. Full-time support people are not eligible for work shift rebates; their rate is set $20 lower than anyone else's because we don't expect them to have time to do a work shift while also providing full-time support for another person.

Partial Registration Options

If attending days only, but making your own lodging arrangements off-site: Subtract $23 per person per day. Please don't check "Overnight" on registration form.

If making your own meal arrangements and not eating meals provided by Autreat: Subtract $26 per person per day. Please don't check "meals" on registration form.

Extra Registration Options

Linens (sheets, blanket, pillow, towels): $5 per person per day or $15 per person for the entire week.
These are "institutional" linens, and we don't know and can't control what laundry products have been used to clean them. If you have tactile issues with fabrics, or sensitivities to certain laundry products, you'll probably be more comfortable bringing your own linens.

Lodging Registration Options

Two or three people will be assigned to each residence hall room.

Additional bunks can be moved in to allow up to four people per room, upon request. There is no extra charge for this, but it must be requested in advance.

Private room: $23 per night (Please cheak "Private room" on registration form).
A waiting list for private rooms will be kept, and rooms allocated based on availability after registration closes. People will be placed on the waiting list based on the date of postmark of their payment of the additional private room fee. In the event we don't have enough rooms available for everyone who requested a private room to get one, those who don't get one will have their private room fees refunded.