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Registration Form
First Name *
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Last Name *
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First name to be displayed on nametag *
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e-mail Address *
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School/Company Name *
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Home Address 1 *
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Home Address 2
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City *
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State *
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Zip *
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Home Phone *
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Professional Information
Primary Role *
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If Teacher, what grade?
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Area of Focus *
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Registration Rates
Registration includes: continental breakfast, lunch and conference costs
Registration is capped at 150 participants.

Refund policy
All refund requests must be submitted in writing and received by January 12, 2019. Requests should be sent to:
Barbara Burns (mathteacherconf@gmail.com)
Conference Chair
There is a $10 non-refundable processing fee on all registrations.

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