2009 ELA Annual Conference Registration

Please complete all information below. If you prefer to register by fax or mail, please print a hardcopy. If you have any questions, please call us at (937) 229-3589. Visit our Conferences page for more information about the 2009 ELA 55th Annual Conference.

Note: Please use the Tab key when moving to the next field. Pressing the Enter key at any time will submit the form.

Registrant Information:
             1. Full Name:
             2. Title:
             3. Nickname to appear on nametag:
             4. Institution or Firm:
             5. Address:
                
             6. City: 
             7. State:     8. Zip Code:
             9. Country: 
             10. Is this address: Home Business Other
             11. Phone:
             12. Fax: 
             13. Email: 
Registration Information:
             1. Registration Type:
                  Regular ELA Member Registration - $305
                         
                  Conference Registration + 1 Year ELA Membership - $435
                         (this fee includes an ELA membership at $130, regularly $145)
                         
                  Regular Nonmember Registration - $455
                          
                  Student Registration (must hold current ELA Membership) - $110

                  Retired Registration (must hold current ELA Membership) - $110
             Special Conference Promotional Discounts (Check all that apply):
                 Early Registration (registration fee paid by August 1, 2009): -$30
                 I am a first-time conference attendee: -$20
                 Bring a colleague (colleague must be a first-time conference
                        attendee)*: -$50 each

                        Colleague's Name
                        Colleague's Name
                        Colleague's Name
                        Colleague's Name
                        Colleague's Name
                        Colleague's Name

                        *$50 discount for any registrant bringing a first-time attendee at the
                        regular member or regular nonmember registration rate. May earn
                        a free registration with 6 regular first-time attendees. No credits
                        beyond a free registration will be given. Promotional discount must
                        be taken at time of registration. All first-time attendees associated
                        with this special promotion qualify for the $20 first-time attendee
                        registration discount.
          
             2. Optional. Wednesday General Preconferences - $95/session):
                  (Select a max. of 2)
                  A.M. General Preconference       P.M. General Preconference
                                         
             3. Optional. Wednesday Regional, All-Day Preconferences ($190 each):
                 Check the box for the specific state of your choice:
                 Kentucky Strand All-Day Preconference
                 Indiana Strand All-Day Preconference
                 Illinois Strand All-Day Preconference
             4. Optional. Continuing Legal Education Credit ($35/state):
                    CLE Bar Number:
             5. Optional. Role-Alike Session - select your group:
                 (no additional cost for paid registrants):
                
             6. Optional. Additional Role-Alike Guest Tickets ($22 / ticket):
                 (no additional cost for paid registrants)
                

             7. Optional. Additional Welcome Reception Guest Tickets ($25 / ticket):
                 (no additional cost for paid registrants)
                

             8. Optional. Additional Business Meeting Breakfast Guest Tickets
                 ($18 / ticket) (no additional cost for paid registrants):
                
            9.  Please check here if you require special accommodations to fully
                         participate. Please include a written description of your needs in
                         the box below:
                         
                          
             10. Payment Type:
                   
                   In order for your credit card to process, you MUST select the credit
                   card button below, AS WELL AS the type of credit card.

                  Credit Card (secure transaction)
                           Visa     Mastercard    American Express
                             Credit Card Number:
                             Expiration Date (MM/YY):    V-Code:

                   If you select the payment options below , you are not considered as
                   registered until we receive payment.

                  Invoice Me (purchase order number required)
                 
                  Check or Money Order
                          (Make payable to Education Law Association)