2012 Legislative Seminar Registration

printable form

Tuesday, February 21, 2012

Online Registration Form

First Name ^* MI Last Name ^*

Employer ^*

Address ^*

City ^* State ^* Zip Code ^*

Phone ^* Ext.

Email ^*

^{WACTE Membership #

Local Association}

^{Not a member? Click here to
join!}

Type of Registration^*

Choose One:
WACTE Member - $110
Non-Member - $140
Student - $40
Registration fee includes lunch, breaks and registration materials.

Method of Payment^*

Choose One:
Check Purchase Order

Check# or PO# ^**if PO # or Check # is not available please enter “to follow”

Conference Attendance Accessibility/Special Needs: If you need disability-related accommodations or have special dietary requests while in attendance at the conference, please identify below:

By submitting this form you are registering for the conference and agreeing to send payment as indicated above immediately. Online registrations will be treated the same as mail in and call in registrations.

Registration deadline is February 6, 2012. Registrations are limited – First come, first served.

Cancellations: A $15.00 administrative fee will be charged for all cancellations. To request a refund before February 6, 2012, send a letter to:
WACTE
2307 Parmenter Street
Middleton, WI 53562
No refunds will be issued after February 7, 2012.

NOTE: All fields with an^* following them must be filled in.