2007 NNER ANNUAL CONFERENCE

Participant Registration Form

SUBMIT THIS FORM ONLY IF YOU ARE NOT SUBMITTING A PROPOSAL
Please print or type information as you would like it to appear on conference materials.

Name ____________________________________________________________

First Name (for name badge) ___________________________________________

Title ____________________________ Dept. ____________________________

School/District/Institution _____________________________________________

Address __________________________________________________________

City ___________________________________ State ______ Zip ____________

Daytime Phone ___________________________ FAX _____________________

Email Address ______________________________________________________

Early Registration (postmarked on or before September 1, 2007) $260.00
Late Registration (postmarked after September 1, 2007) $300.00
Free Registration Request - must comply with the rules and procedures outlined here

Registration fee includes all conference sessions (Thursday, Friday, and Saturday), Friday and Saturday continental breakfasts, Thursday reception, Friday and Saturday luncheons, Friday evening’s Cultural Center event, and conference materials.

PAYMENT: CHECK ONE PLEASE

Check Enclosed (Make checks payable to USC)

Amount Enclosed ________________________

VISA
MasterCard
DiscoverCard
Acct. # _____________________________ Expiration Date _________________

Cardholder's Signature (Required) _______________________________________

Date _________________

Credit card registrations may be completed by fax transmission. Please transmit completed registration form with method of payment to (803) 777-3035. Our Federal Tax I.D. number is 57-6001153.

I have read and agree with the policies stated in this brochure.

__________________________________________________________________
Registrant's Signature

I am disabled and may require assistance from conference staff.

Complete registration form and mail to:

2007 NNER National Conference
University of South Carolina • College of Education
Wardlaw 252• Columbia, SC 29208
Phone (803) 777-1515• Fax (803) 777-3035

Early Registration deadline: September 1, 2007!

ENRL ________ LOG# ________ MTH ________ APPVL ________ RECP# ________ RFDATE ________

Contact Us