FCSC

Attendee Registration

Step 1 of 4

Registration is $195 per attendee. The deadline to register is October 20, 2008, with payment being received by October 31, 2008. After the October 20 deadline, only onsite registrations will be accepted, at the higher rate of $250. The fee is non-refundable, but is transferable to a replacement attendee.

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
Badge Name	*
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	*
Extension
Work Fax
Other Phone

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

August 28, 2008

Attendee Registration

Hotel Reservations

Call for Presentations