LACUE 2008 Conference Registration Form

A registration form MUST be completed by each attendee. * indicates a required field.
Name:
*First Middle   *Last  
     
Home Address:
*Home Street
*Home City
*Home State
*Home ZIP
School or Business
*School or Business Name:
*Street:
*City:
*State:
*Zip:
Preferred mailing address: Home School/Business 
School Parish  
Contact Information:
Home Phone
*Work Phone
Fax
Home Email
*Business Email
Preferred Email Home  School/Business  Both
You will receive an email confirmation at the preferred email address you select above.
Information release:
Check the appropriate box if you do not want your address released to:
other LACUE members
commercial vendors.
Leadership Luncheon
The Leadership Luncheon is FULL. If you are interested in attending, please plan on waiting outside the luncheon meeting room. If pre-registered luncheon attendees are not in their seats 10 minutes after the luncheon begins, the doors will be opened for other attendees to enter if seating is available.
Sorry the luncheon is full. Yes, I would like to attend the free Thursday Leadership Luncheon and Business Meeting. (The Luncheon will be limited to the first 700 respondents).
 
Professional Affiliation   Professional Position
College/University   Teacher
Secondary   Para-Professional
Middle/Junior High   Administrator
Elementary   Supervisor
School Board   Technology Trainer
BESE Member   Technical Support
State Department of Education   Consultant
Business   Board Member
Other   Legislator
If Other, please specify:
  Salesperson
      Other
      If Other, please specify:  
   
$ 135 .00 Full Conference (Includes complimentary LACUE membership.)
$30.00 Spouse/Guest (Includes Exhibits, Socials & Reception)
Spouse/Guest Full Name:
$79.00 Optional ISTE Membership
*TOTAL AMOUNT
Payment options
I will pay with a credit card
I will pay with a check
*Check#
*Name as it appears on check
Bill me on Purchase Order.
*Purchase Order#
*Name
*School/School Board
*Street
*City
*State
*Zip
Please be sure all information is correct on the above form. Pressing submit will register you for the LACUE conference. Please press “submit” only once, as pressing more than once, or going back and re-submitting will result in duplicate registrations