Florida Charter School Conference

Attendee Registration

Step 1 of 4

Registration is $195 per attendee. The deadline to register is October 21, 2011, with payment being received by October 28, 2011. After the October 21 deadline, only on-site registrations will be accepted, at the higher rate of $250.

CANCELLATION POLICY: The fee is non-refundable, but is transferable to a replacement attendee. Please email Noelle Bonard to make arrangements for your replacement.

Please complete this form in its entirety, making sure the items indicated as required are completed.

*Required information

Contact Information
Prefix
First Name *
Last Name *
Suffix
Nickname
If different than your first name. For example - If your first name is William but you go by Bill, please list Bill as your nickname.
Job Title
Organization *
FL School District
Work E-mail *
Other E-mail
Primary Address Work Home
Address 1 *
Address 2
City *
State *
Zip *
Country *
Work Phone *
555-555-5555
Extension
Other Phone
555-555-5555
 
Other Information
Information Release I do I do not give my permission for you to share information in addition to my name (e.g., position, office phone, and e-mail address) on a participant list, to be distributed to all who attend the conference, and to be photographed for possible use in conference materials.
Work Area
Special Needs I request accommodations for a disability.
You will be contacted by a conference staff member to make arrangements.
Dietary Requests Standard
Vegetarian
Kosher
Other
Food Allergy
 

 

 

 

 

 

FCSC

 
© 2011 Florida Charter School Conference | Privacy Policy | Last Updated: April 20, 2011