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2010 Regional Conference Registration
(Please fill form out completely so we can process your request.)


TexTesol IV Regional Conference Registration
University of Houston
October 30, 2010



If you would like to download a Hard Copy of the form to mail in you can do so. Just Click Here

Mail completed form with payment to:
Kimberly Mitchell,
Katy ISD, DOL
6301 S. Stadium Ln.
Katy, TX 77494
For questions, email : registration.textesol4@gmail.com
Or
pay on line: PayPal
Early Registration Deadline : October 9, 2010 (Lunch included. No refunds after Oct. 9, 2010)

Name * *
Institution/District:
Street: *
City * *State
Zip code *
Phone (H) * () -- Phone (W)() --
Willing to volunteer:
Email: *
* Standard Early Registration (must be submitted by 10/09/10) $80 (Lunch included)
* Standard On-Site registration $85 (Lunch on your own)
* Full Time Student Early Registration $50 (Lunch included)
* Full Time Student On-Site Registration $50 (Lunch on your own)

TECHNOLOGY:

Are you a Presenter?
If yes, please type in the boxes a quantity for each item needed below: Note: This year, TexTESOL IV has waived the first $15.00 of technology fees for presenters.

* Screen and cart for those bringing own laptops and LCD Projectors (Complimentary)
* Transparency Overhead Projector, screen (Complimentary)
* LCD Projector for those bringing own laptops ($100)
* Flip Chart and easel/markers (Complimentary)
* DVD/VCR (Price available upon request)
* Presenter will bring own equipment if needed (no on-site tech)
PAYMENT METHOD
Please list the Check or P.O. #
include the name(s) of all registrants