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Registration
**You can either print this page or print a Microsoft
Word version of the registration form from the
following link.**
Positive Psychology and Health: Building the Best Things in Life
Rush-Presbyterian-St. Luke's Medical Center
Chicago, Illinois
August 21, 2002
Please print or type:
Name ____________________________________________
(as you would like it to appear on your badge)
Institutional Affiliation: ____________________________________________
| Mailing Address: |
__________________________________________________ |
| |
__________________________________________________ |
| |
__________________________________________________ |
Work Telephone: _______________________ Home Telephone: _________________________
Email: _________________________________ (note: email will be used for
communication)
Please indicate your preference for breakout sessions by checking one
program for each session:
Breakout Session I
____ How to Grow Spiritually: A Positive Psychology Perspective
Carl Thoreson, Ph.D., Stanford University
____ Qualitative Methods in Positive Psychology Research
Kathleen Chwalisz, Ph.D., Southern Illinois University
Breakout Session II
____ Promoting Hope, Optimism, Well-Being: Programs that Work
Shane J. Lopez, Ph.D., University of Kansas
____ Critical Issues in Researching Quality of Life
Elizabeth Altmaier, Ph.D., University of Iowa
Please indicate any special assistance or accommodations you might need
(e.g., due to disability):
| Conference Fees (circle one): |
|
Before August 1 |
August 1 to 10 |
| Physician |
$125.00
|
$150.00
|
| Psychologists (CE Credits) |
$ 75.00
|
$ 90.00
|
| Professional or Resident (no CE) |
$ 60.00
|
$ 75.00
|
| Students |
$ 30.00
|
$ 45.00
|
* Rush employees receive $10 discount from prices above
Fees include admission to all conference activities, breakfast, lunch
and refreshment.
Make personal check, cashier's check, or money order out to Positive Psychology/Health
Conference
Send form and check to:
Daniel L. Clay, Ph.D.
Rush Conference Registration
361 Lindquist Center
University of Iowa
Iowa City, IA 52242
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