Form

The IAACE Conference will be held in Frech Lick Indiana on Thursday, April 25th and Friday, April 26th, 2013. Conference check-in, hospitality event, and networking activities will begin at 5:00pm EST on Thursday. Conference check-in and sessions will begin at 7:30am EST on Friday.

Cost to attend the conference is $150 and includes a one year membership to IAACE.

Details about the Conference can be found at the IAACE website: www.IAACE.com

This form is used for registering for the conference only. You will still need to make hotel arrangements if needed.

Please fill out the form below. Please read the directions regarding payment carefully.

First Name: *

Last Name: *

Email Address:

Phone Number: *

Mailing Address: *

City: *

State: *

Zip Code: *

Organization/School: *

Registration Type: *

Will you be attending the Hospitality Event on Thursday evening? *

yes no

Please list any special dietary or other needs: (If none, please leave blank)

Are you a current member of IAACE? *

yes no not sure

You can check your membership status by sending an email to Jeff Clutter at jmc@vigoschools.org

Conference Registration - $150.00

includes complimentary, one-year membership

Membership will be effective starting April 25, 2013

How would you like to pay for your Registration and Membership? *

online via Paypal or credit card mail a check Purchase Order

To pay by check:

Please send checks to:

Vigo County School Corporation

ATTN: Jeff Clutter

P.O. Box 3703

Terre Haute, IN 47803

Please make checks payable to IAACE.

If paying for multiple registrations with the same check, please include the names of the registrants with the check. Each person should register individually via this form.

When finished, please hit the submit button to finish the registration process.

Purchase Order #:

To pay by Purchase Order:

If your school corporation or organization is going to pay with a PO, please enter the PO number above. Your administration should send a copy of the PO to the address below or email a copy to jmc@vigoschools.org. Please include all the names that the PO is covering.

Vigo County School Corporation

ATTN: Jeff Clutter

P.O. Box 3703

Terre Haute, IN 47803

When finished, please hit the submit button to finish the registration process.

Pay via Paypal: *

Conference Registration $ 150.00 USD
Dummy $ Free USD

When you hit submit, you will be taken to the Paypal page to complete your registration.

IAACE 2013 Conference Registration