Register:                                   Price
Retired Member                    47.50
Member                               95.00
Non-Member                      115.00
Friday ONLY Attendee          85.00
Late Fee (after March 29)           10.00

Total Registration            $________

First Timer (Please check box.)

Registration Form

Name________________________________________________

Address______________________________________________

City______________________________ Zip_________________

USD#__________ Agency Name _________________________

Home Phone_______________ Work Phone ________________

Email ________________________________________________

Office Use Only

Date Received_______________________

Registration#________________________

PO#______________ Check#__________

USD#_____________ Amount Received_____________

Please check the meals you plan to attend which are part of your registration fee:
Open House   Friday Luncheon
      (Snack Only)        Friday Banquet
                           Saturday Breakfast
Special Dietary Needs or Disability:

Guest meals: Please contact Denise Shockey at 316-204-5912 or Debora Jensen at 316-721-0944.

Print, complete and send to:
KAEOP Spring Workshop 2008
Debora Jensen, Registrar
275 S Maple Dunes Ct
Wichita, KS 67235
Home: 316-721-0944
Work: 316-973-0401
Fax: 316-973-0410
Email: djensen@usd259.net

Please return this completed form and check or school purchase order made payable to:
                                           KAEOP

Registrations postmarked after March 26, 2008 will pay a late fee of $10.00. Registration cancellations must be in writing sent via FAX, e-mail, or letter. No refunds will be given after March 31, 2008. Please make a copy of your registration form to use as your invoice if you are sending a purchase order. If paying by purchase order, please ask your district to make payment in a timely manner.