Gold Standard 2012 Registration

REGISTRATION FORM
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It is necessary for correct price calculations that you use the TAB key to move through the fields on this form
or click on the Total Due Field before clicking Submit.

3/19/2012 Food Counts Have been turned in. We cannot guarantee you a lunch!

First Name	*
Last Name	*
Organization
Title:
Email Address	*
Phone Number	*
Fax Number
Address	*
City	*
State	*
Zip Code	*

Number of Days Attending:
Reg Type:	*
Day(s) Attending: Do NOT mark any days if you selected Full Conference.
		Wednesday Thursday Friday
Registration Total: *

Lagniappe: Ordering from this section ends February 24. Any items selected from this section after February 24 will not be filled.

A Syllabus on CD will be provided to every registrant.
You may choose to receive a printed copy, or a flash drive for an additional fee.
Click here to indicate if you wish to receive these "extra" items.
Syllabus Options:		Flash Drive Printed Syllabus
Syllabus Total:

Awareness Run/Walk		Yes

Pre-Order Books:
CLOSED
A limited quantity of the books designated with an asteriisk will be available in the conference bookstore.
All other books are available by pre-order only.

Balancing Breast and Bottle, Peterson & Harmer, $21.95 QTY:
Best Medicine: Human Milk in the NICU; Wight, Morton, & Kim= $32.95 Qty:
Breastfeeding & Diseases; Buescher, & Hatcher =$24.95 Qty:
Breastfeeding and Human Lactation, 4th Edition; Riordan & Wambach= $124.95 Qty:
Breastfeeding and Natural Child Spacing, The Ecology of Natural Mothering; Kippley= $14.95 QTY:
Breastfeeding Answers Made Simple, Mohrbacher,=$79.95 QTY:
Breastfeeding Atlas, Wilson-Clay=$59 QTY:
Breastfeeding in Combat Boots, Roche-Paull=$29.95 QTY:
Breastfeeding Made Simple: Seven Natural Laws for Nursing Mothers; Mohrbacher, Kendall-Tackett=$18.95 QTY:
Breastfeeding Management for the Clinician: Using the Evidence, Walker=$72.95 QTY:
Breastfeeding Mother’s Guide to Making More Milk, West=$17.95 QTY:
Breastfeeding: A Guide for the Medical Professional, Lawrence=$96.95 QTY:
Breastfeeding: An Illustrated Guide To Diagnosis and Treatment; Both, Frischknecht=$59.95 QTY:
Breastfeeding: Mom and I Can Do That, Cox=$49.95 QTY:
Clinical Therapy in Breastfeeding Patients; Hale, Berens=$29.95 QTY:
Clinician's Triage Tool = $2.00 QTY:
Clinics in Human Lactation:
-Altering Hospital Maternity Culture: Current Evidence for the Ten Steps to Successful Breastfeeding, Cox=$18.95 QTY:
-Breastfeeding after Breast and Nipple Procedure; West, Hirsch=$18.95 QTY:
-Breastfeeding the Late Preterm Infant, Walker=$18.95 QTY:
-History and Assessment: It's All in the Details, Altman=$18.95 QTY:
-How Breastfeeding Protects Maternal Health Throughout the Lifespan=$18.95 QTY:
-Mentoring Our Future. Altman=$18.95 QTY:
-The Nipple and Areola in Breastfeeding and Lactation, Walker=$18.95 QTY:
-NonPharmacologic Treatments for Depression, Kendall-Tackett=$18.95 QTY:
Colic Solved: The Essential guide to Infant Reflux and the Care of Your Crying, Difficult-to-Soothe Baby, Vartabedian=$13.95 QTY:
Complementary and Alternative Medicine in Breastfeeding Therapy=$19.95 QTY:
Comprehensive Lactation Consultant Exam Review, Third Edition, Smith=$78.95 QTY:
Continuity of Care in Breastfeeding: Beast Practices in the Maternity Setting; Cadwell, Turner-Maffei=$58.95 QTY:
Core Curriculum for the Lactation Consultant Practice, Walker=$84.95 QTY:
Counseling the Nursing Mother, Fifth Edition A Lactation Consultant's Guide; Lauwers, Swisher=$87.95 QTY:
Defining Your Own Success: Breastfeeding After Breast Reduction, West=$24.95 QTY:
Doulas' Guide to Birthing Your Way; Mallak, Bailey=$21.95 QTY:
Hale & Hartmann's Textbook of Human Lactation; Hale, Hartmann=$89.95 QTY:
Hidden Feelings of Motherhood, Kendall-Tackett=$14.95 QTY:
Human Milk in the NICU: Policy into Practice, Arnold=$68.95 QTY:
Impact of Birthing Practices on Breastfeeding, Second Edition, Smith=$61.95 QTY:
Interaction and Relationships in Breastfeeding Families, Epstein-Gilboa=$34.95 QTY:
Introduction to Biological Nurturing, An; Colson=$19.95 QTY:
Keep the Fires Burning: Conquering Stress and Burnout as a Mother-baby Professional; Jones=$19.95 QTY:
The Latch and Other Keys to Successful Breastfeeding; Newman, Pitman=$24.95 QTY:
Legal & Ethical Issues for the IBCLC; Brooks=$52.95 *Pre-release order will ship to you when released from the Publisher in late April or Early May 2012!) QTY:
Little Green Book of Breastfeeding Management, 5th Ed.; Hertz=$10.00 QTY:
Lullaby Massage: Rhyme & Touch Massage for Infants and Children, Hart=$14.95 QTY:
New Insights into Vitamin D During Pregnancy, Lactation, & Early Infancy; Wagner, Taylor, Hollis=$24.95 QTY:
Nonprescription Drugs for the Breastfeeding Mother, Nice=$19.95 QTY:
Passionate Journey: My Unexpected Life=$19.95 QTY:
Postpartum Depression At A Glance, Kendall-Tackett=$9.95 QTY:
The Problem with Breastfeeding: a Personal Reflection, Akre=$19.95 QTY:
Regulating Infant Formula; Kent=$18.95 QTY:
Selecting and Using Breastfeeding Tools, Watson Genna=$32.95 QTY:
Six Mothers Six Stories of Disability; Wilson=$18.95 QTY:
Sleeping with Your Baby, A Parent’s Guide to Cosleeping, McKenna=$14.95 QTY:
Spanish for Breastfeeding Support; Glick, Lieberman=$39.95 QTY:
Start Here: Breastfeeding and Infant Care with Humor and Common Sense; McCue=$17.95 QTY:
Supporting Sucking Skills in Breastfeeding Infants, Watson-Genna=$65.95 QTY:
Tongue Tie: Morphogenisis, Impact, Assessment and Treatment; Hazelbaker=$52.95 QTY:
The Womanly Art of Breastfeeding=$20.00 QTY:
Working Without Weaning: a Working Mother's Guide, Berggren=$24.95 QTY:
Book Total:
Lagniappe Total:

Please help us ensure adequate seating by clicking the button for each and every General Session you plan to attend.
Wednesday, March 21, 2012
G1: Marcus		Breastfeeding as a Civil Right: How US Law Works, Marcus
G2:West		Overcoming Breastfeeding Ambivalence
5:00 – 6:30 PM Free Time: Hotel Check-In, Dinner On Own
O1: McGrath		How to Nurture a Broken Heart
O2:DeArmond, Foretich, & Zeretzke		Pear Lead Study Group

Thursday, March 22, 2012
E1: West		Assessing Milk Production and Milk Intake
G3: Marcus		Breastfeeding as a Civil Right in Public Accomodations
Thursday Morning Breakouts (Choose ONE)
101: Glenn		IBCLC-Why You Need Me
102: Saenz		Anesthesia and Breastfeeding Mothers (Repeated 402)
103: Black Bear		Designing and Implementing a Mother-to-Mother Support Group
104: Bomer-Norton		Community Breastfeeding Network
12:15 - 1:15 PM: Thursday Luncheon (Please indicate choice) and Stretch Break

Describe Special:
Thursday Afternoon Breakouts (Choose ONE)
201: Helmstetter		Teen Scene - Breastfeeding Queen (Repeated as 401)
202: Pittman		Mothers' Milk Bank of Mississippi: What is a Child Worth?
203: Vickers		Life Course Theory and Social Determinants of Health. (Repeats as 403).
204: Nybo		The Business Case for Doulas (Repeated as 404)
G4: Marcus		Workplace Pumping as a Civil Right
4:15- 4:45 PM Dessert and Coffee break
G5: West		Using Technology in Your Lactation Consultant Practice
6:00 PM Free Time/Dinner: (Choose ONE)
ALL SPEAKERS Please Select - Speaker Dinner @ Dragos!!


Friday, March 23, 2012
E2: West		Helping Breastfeeding Working Mothers
G6: Marcus		World Peace Begins at Home: Domestic Violence and the Breastfeeding Mother
Friday Morning Breakouts: (Choose ONE)
301: Lucas		Supporting Breastfeeding in Child Care Centers
302: Regan		Coalitions/Associations/Organizations for Breastfeeding Support
303: Black Bear		Designing and Implementing a Mother-to-Mother Support Group (Repeated from 103)
304:Brewer-Aisling, Deaton, Glenn, Reger, & Landry		Geauxing Out of Our (Southern Comfort) Zone: Changing a Cultural Norm in Louisiana Through Coalitions
12:15 - 1:15 PM Award Luncheon with Dessert, (Indicate Choice of Meal), and Stretch Break

Describe Special
Friday Afternoon Breakouts: (Choose ONE)
401: Helmstetter		Teen Scene - Breastfeeding Queen (Repeated from 201)
402: Saenz		Anesthesia and Analgesia in Breastfeeding Mothers (Repeated from 102)
403: Vickers		Life Course Theory and Social Determinants of Health. (Repeated from 203)
404: Nybo		Business Case for Doulas (Repeated from 204)
G7: Marcus		Breastfeeding 2.0: Law and Ethics in Providing Breastfeeding Support Using the Internet
4:15-5:00 PM Closing Session: Evaluations/wrap up/door prizes

Breakfast Tickets: (For those not staying @ the Hampton)
#
Breakfast Total:

Extra Lunch Tickets:(These are IN ADDITION to the lunch ticket you will receive with your paid registration.)
Total Extra Lunch Tickets for Thursday:
Please indicate Thursday lunch choice:
# Meat
# Veg
# Fish
# Special
Describe Special
Total Extra Lunch Tickets for Friday:
Please indicate Friday lunch choice:
# Meat
# Veg
# Fish
# Special
Describe Special
Extra Lunch Total:

Extra Speaker Dinner Tickets: (In addition to the one which may have been ordered above on your registration)
Extra Drago's Tickets QTY:
Extra Dinner Total
Extras Total:

Subtotal: (Registration + Lagniappe + Speaker Dinner + Extras)
Scholarship		I received a full registration scholarship I received a reduced registration scholarship

The following may receive a discounted price:
General Public not requiring Continuing Education Units:
La Leche League Leaders
WIC Breastfeeding Peer Counselors
Students with valid ID
Select the days you are attending from the list below:
		Full Conference
		Wednesday
		Thursday
		Friday
Conference Speakers: Please indicate the days you are speaking.....
		Full Conference
		Wednesday
		Thursday
		Friday
Total Due: *

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Make all checks payable to: Breastfeeding: The Gold Standard
PayPal payments may be sent to: funds@breastfeedingthegoldstandard.org
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