2009 Winter Literacy Conference – February 7, 2009
Please print this page, fill it out and send it, along with your payment to the address listed below.
Participant Registration Form
Please print or type information as you would like it to appear on conference materials.
First and Last Name ______________________________________________________________________
Name as you would like it to appear on name badge _______________________________________
Title _________________________________________
School/District/Institution _____________________________________________________
Home Address _____________________________________________________________
City ________________________________________ State _________ Zip ____________
Daytime Phone ___________________________ FAX _____________________________
Email Address _____________________________________________________________
Registration - $100.00
Full time students - $55.00
Registration fee includes all conference sessions and luncheon.
PAYMENT:
Check Enclosed (Make checks payable to USC)
Amount Enclosed ________________________
Our Ferderal Tax I. D. number is 57-6001153
A receipt will be sent to you via e-mail upon receipt of payment.
Mail completed registration confirmation page and check to:
University of South Carolina
2008 Fall Literacy Conference
Attention: Julie Niehaus
College of Education
820 South Main Street
Wardlaw 002
Columbia, SC 29208
Phone (803) 777-5295 • Fax (803) 777-3193
Direct inquiries to: Julie Niehaus, niehaus@mailbox.sc.edu