2010 Conference Registration
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Attendee Information
Enter Member Number
Prefix
First Name
Middle Name
Last Name
Suffix
Address 1
Address 2
City/State/Zip ,
Country
Home Phone
Work Phone
Email Address
Work Setting
Current Job/Position:
First Time Attendee
Previous Conferences Attended
Vegetarian
Special Needs?   If yes, please explain.
Badge Information
Name
Name of School/Institution
School City
School State
Pre-Conference Workshops
  Full Day
(9-4)
  $70.00 
Half Day AM
(9-12)
$35.00 
Half Day PM
(1-4)
$35.00 
Featured Speaker $50.00  Sylinda Gilchrist Banks, Ph.D.     9 am-12 p.m.     
Conference Registration Rates
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Non Members   $495.00  
Presenters   $275.00  
Principals   $250.00  
One Day 7/3   $175.00  
One Day 7/4   $175.00  
One Day 7/5   $175.00  
One Day 7/6   $175.00  
Registrant Options
Opening Reception - $0 For Attendees
  I wish to attend the opening reception.    
I do NOT wish to attend the opening reception.    
Recognition Dinner - $75 For Attendees
I wish to attend Recognition Dinner.  
I do NOT wish to attend Recognition Dinner.    
Fourth of July Celebration
I wish to attend the Fourth of July Celebration. - $15.00  
I do NOT wish to attend the Fourth of July Celebration..    
Guest Registration
Guest registration is $175. It includes access to the exhibit hall, opening reception, and lunch in the exhibit hall on Sunday and Monday.
  Name of Guest 1
  Name of Guest 2
  Name of Guest 3
  Name of Guest 4
  Name of Guest 5
Additional Guest Tickets
Opening Reception - $30.00 Qty Total $
Recognition Dinner - $75.00 Qty Total $
Fourth of July Celebration - $15.00 Qty Total $
Payment Type
District Credit Card Personal Credit Card