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. Contact information must be that of the
individual presenter to insure proper delivery of NAPDS benefits.
PRE-REGISTRATION DEADLINE: MARCH 1, 2009!
Dr.
Mr.
Ms.
Name _________________________________________________________________
First Name (for name badge) ________________________________________________
Title ____________________________ Dept/District. ____________________________
Pre-Registered Single Participant $420.00 (postmarked before March 1, 2009)
Pre-Registered Group Participant $390.00 each (Groups of 4 or more participants from the same institution whose registrations are received together)
Full-time Student - 2 for $205.00 (Requires verified current enrollment in at least 9 (credit) semester hours, must accompany registration.
A separate registration must be completed for each student. Both registrations must be received together and be from the same institution.)
Late Registration $445.00 (After March 1, 2009)
Registration fee includes the conference sessions (Thursday, Friday, Saturday, Sunday), continental breakfasts, receptions, Friday and Saturday lunches, and conference materials.
PAYMENT: CHECK ONE PLEASE
Check Enclosed (Make checks payable to USC)
VISA
MasterCard
DiscoverCard
Name on credit card _________________________________________________
Acct. # _____________________________ Expiration 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 cancellation policy stated in this brochure.
I am disabled and may require assistance from conference staff.
Complete registration form and mail to:
2009 PDS National Conference
University of South Carolina • College of Education
Wardlaw 252• Columbia, SC 29208
Phone (803) 777-1515• Fax (803) 777-4807
