OSTA CONFERENCE REGISTRATION FORM

2003 OSTA Annual Conference

October 10, 2003

Science at the Summit

Summit High School

Bend , Oregon

 

Name ________________________________________________________________

                (Last)                            (First)                         (Middle Initial)

Address ______________________________________________________________

          (Street Address)

______________________________________________________________

                  (City)                   (State)                           (Zip Code)

 

Home Phone  (____)_______________       Work Phone  (____)________________

Email ____________________________________    Fax  (____)________________

School or Agency ____________________________________________________

Position: Elementary Middle  Secondary  Post-Secondary Other

Mark the appropriate boxes and make check payable to OSTA.

In order to qualify for Advance Registration price, your Registration Form must be postmarked by Friday, September 26, 2003 .  After September 26, please pay the onsite price.  Payment must accompany the registration form to be processed.

Conference Registration - Select one

$75 OSTA Conference Advance Registration and Membership.  Includes one-year membership, one-year TOST subscription, lunch, and conference registration.  (postmark by 9/26)

$95 OSTA Conference On-Site Registration and Membership.  Includes one-year membership, one-year TOST subscription, lunch, and conference registration.  (postmark after 9/26 or at door)

$25 Student and Retired Teacher OSTA Conference Advance Registration and Membership.  Includes one-year membership, one-year TOST subscription, lunch, and conference registration.

$35 Student and Retired Teacher OSTA Conference On-Site Registration and Membership.  Includes one-year membership, one-year TOST subscription, lunch, and conference registration.

Payment Worksheet

Conference Registration       _________

Friday High Desert Museum Gala

*Limited to 250 attendees 

($5 per person)                  _________  

Total                               _________

 

Do you have any special needs or dietary restrictions that we can address to make your participation more enjoyable?  Please call SueAnn I. Bottoms at (541) 737-4653 by Sept. 5 so we can make the necessary arrangements.

Refund/Cancellation Policy: Written refund requests must be postmarked 10 days before the conference.  Refund/Cancellation does not include the $30 OSTA membership portion of the fee.

Mail to: 

Paul Zastrow, OSTA Registration,

5690 Collins Road , Hood River , OR 97031

 

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