Complete the below form to register as a UCCR member:
 
Name:
Company:
Contact Information   (for use by UCCR Administrator)
Address:
City:
State:
Zip:
Phone:
Alternate Phone:
Email:
 
Contact Information to be posted on the Website   (if different from above)
Address:
City:
State:
Zip:
Phone:
Email:
   
Biography  (not required)
 
As a member of the Utah Council on Conflict Resolution, you will receive discounts on symposia, conferences, and educational opportunities sponsored by UCCR. You will have your name and contact information listed on the UCCR website. You will also receive copies of the quarterly UCCR newsletter as well as email updates about UCCR activities.
 
Membership Category
Member. Please sign me up as a Member of the Utah Council on Conflict Resolution.
Annual dues: $75.00
Student. Please sign me up as a Student Member of the Utah Council on Conflict Resolution. I understand that I must provide proof of enrollment in a degree or certificate program at an accredited college or university. Annual dues: $25.00
Family Mediation Section. Please sign me up as a Member of the Family Mediation Section. Membership requires UCCR membership and additional Additional annual dues of $20.00.
Workplace Mediation Section. Please sign me up as a Member of the Workplace Mediation Section. Membership requires UCCR membership and Additional annual dues of $20.00.
Southern Chapter. I live in the Southern part of the state and would like to be identified as a Southern Chapter Member. No additional dues required.

Utah County Chapter. I live in Utah County and would like to be identified as a Utah County Member.

No additional dues required.
   
Payment Method
Total Due:   $
Online Payment
 
Make a secure payment online using PayPal
(an account with paypal is not required).
Check
 

Please write Check payable to Utah Council on Conflict Resolution and mail to:

Utah Council on Conflict Resolution
P.O. Box 521656
Salt Lake City, Utah  84152-1656

Contact the UCCR Administrator at 801-685-8227 (UCCR) or info@uccr.net with questions.

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