Missouri State University

Skip search and site index

MIDTESOL
Conference
Registration
Form

 

October 16-17, 2009
Missouri State University • Springfield, Missouri

 

 

Online registration is for credit card payment only. If you prefer to make payments by check, money order, or PO, please download the registration form and mail it with your payment to the following address.




SUBMIT REGISTRATION FORM TO:
Jim D. Morris Center, English Language Institute
301 S. Jefferson Ave. Springfield, Missouri 65806

 

ONLINE REGISTRATION FORM

*Please select your registration date and type

Pre-Conference Workshop is limited to 22 participants for each registration type.

October 16, 2009: Pre-Conference Workshop (choose one)
Doing Assessment Right at the Post-Secondary Level
$30
Carthage School District Visit
$30
Not Attending

 

October 16 & 17, 2009: Conference Registration (choose one)

(Includes Friday night reception and Saturday lunch)
Member Fee, $70
(After Sept. 16, $80)

Non-Member Fee, $85

(After Sept. 16, $95)

Student, $35.00

(Valid student ID is required at the conference)

(Includes Friday night reception and Saturday lunch)

 

Institution Name

 

Conference Afternoon Sessions

Special Workshop

By Dr. Kathleen M. Bailey (additional $25)

Concurrent Sessions

(no additional fee)

 

ATTENDEE CONTACT INFORMATION

 

Name
Email
Home Address
City
State Zip

Home Phone
Cell / Phone

 

CANCELLATION POLICIES

Cancellation must be submitted seven (7) days prior to the workshop to ensure a full refund minus a 15% processing fee. Cancellations after the seven day deadline will garner no refunds. You may send another person to substitute your seat without any cost.

 

I have read the cancellation policy and agreed to its terms.

 

Payer's Name