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2013 Utah Early Childhood Conference Reg Form-1
2013 Utah Early Childhood Conference Reg Form-1
2013 Utah Early Childhood Conference Reg Form-1
Online: www.spedregistration.com
Phone: 801-957-5200 or 801-957-5201
Fax: 801-957-5328
Email: MillerEvents@slcc.edu
Mail: Salt Lake Community College
SPED Registration MPDC 110
9750 South 300 West Sandy, UT 84070
Registration Information:
Registration Options:
Type of Program (Check All That Apply):
Session Options
UAEYC Member
Administrator
Center Child Care
Head Start/Early Head Start
Preschool
Early Intervention
After School
Family Child Care
Kindergarten Student
Primary Grade
Student
Please list your top four choices for each session you wish to attend
Session 1 -- 10:15am-11:15am
1________ 2________ 3________ 4________
Session 2 -- 12:15pm-1:30pm
1________ 2________ 3________ 4________
Conference Fee:
$20.00 Keynote only (no lunch or sessions)
$35.00 Early Bird full conf. (w/lunch) Feb 11 - 28
$45.00 Regular full conf. (w/lunch) Mar 1-8
Committee Member/Volunteer /Presenter: To Register, contact
Celia Duarte at 801-957-5312
Session 3 -- 1:45pm-3:00pm
1________ 2________ 3________ 4________
Session 4 2.5 Hour Session-- 12:15pm-3:00pm
If registering for Session 4, please do not register for Session 2 or 3.
Total: $____________
Please select preconference events on Friday March 22, 2013 you plan to attend (no
additional fee). Show registration receipt for entrance.
I will not be attending preconference events
I plan to attend Night at the Museum event
I plan to attend Tours of NAEYC Accredited Programs
I plan to attend the Lakeshore Learning Workshop
For more information please visit:
http://www.utahearlychildhoodconference.com/p/preconference-events.html
Payment Options:
Credit Card
Visa
AMEX
MasterCard
Discover
Purchase Order
________________________________________________
City:______________________ State: ______ Zip: _____
Phone #: _______________________
Signature: ________________________________________
#:__________________
UAEYC may share its mailing lists with NAEYC and conference sponsors, check her to have your name removed
Date: