Annual Conference Registration

ALTERNATIVE ENERGY: POWERING MIDDLE LEVEL LEARNING
At Green River Community College and Rainier Middle School
April 23 - 24th, 2010

One form per registrant. Form may be duplicated. Each member of a team should submit a form (This is how we do our meal/materials count).

Last Name First Name

JOB TITLE (CHECK ONE)

ADMINISTRATOR TEACHER CENTRAL OFFICE
PARENT UNIVERSITY PROFESSOR SPEAKER
CURRICULUM GUIDANCE TECHNOLOGY
LIBRARY STAFF STUDENT list college/university
OTHER    
 
GRADE SUBJECT(S)
SCHOOL/ ORGANIZATION
HOME ADDRESS
CITY STATE ZIP
Phone (W) ext. Phone (H) Mobile

EMAIL - please give your home email

I require special assistance. I have special dietary needs. Please give details :
 

CONFERENCE LOCATIONS

REGISTRATION FEE for 2-DAY EVENT

Fri: Green River Community College Individual Registration $125.00
12401 SE 320th Street WAMLE Member Registration $100.00
Auburn, WA 98092-3622 Student Registration $50.00
  Presenter fee waived
Sat: Rainier Middle School Team of 5/pay for 4 SPECIAL $400.00
30620 116th Ave. SE  
Auburn, WA 98092-3161  
   
NOTE: Clock hours are available; breakfast, lunch & conference materials included both days.

PAYMENT INFORMATION

 
CHECK - Payable to WAMLE ($20 fee for returned checks) Please return completed form to:
WAMLE Conference Registrar Fax: 360-647-6887
Stephanie Strow  
Fairhaven Middle School  
110 Park Ridge Road  
Bellingham, WA 98225  

To pay using PayPal; you don't need to have a PayPal account to use this.(You still need to send in this form!):

Type of Registration