2018 CEC Convention Registration Form
"Not All Heroes Wear Capes: Champions for Exceptional Children
Mississippi Council for Exceptional Children
DEADLINE FOR EARLY REGISTRATION IS AUGUST 10, 2018
* Required
Personal Information
Please complete this entire form for each individual attendee.
Last name
*
Your answer
First Name
*
Your answer
School/ District/Agency
*
Your answer
Job Title
Your answer
Email
*
Your answer
Mailing Address
*
Your answer
Phone number
*
Your answer
Fax
Your answer
Convention Fee Information
If you are taking advantage of the group pricing, please provide the names of the people included in your group in that section.
Convention Fees (Prior to Aug 10th)
MS CEC member $150
Non-member $175
MS CEC Student Member $25
Parents, Paraprofessionals $75
Convention fees (After Aug 10)
MS CEC member $175
Non-member $200
MS CEC Student Member $50
Parent, Paraprofessionals $100
Convention Fees (Group Pricing- 10 or more)
Sending 10 or more attendees $150
Provide names of persons in your group
Your answer
Will you be attending the pre-conference MIDAS training on August 27th? (at no additional fee)
*
Yes
No
Do you require any special accommodations?
Your answer
Payment Information
Please make checks payable to MS- CEC (checks may be for multiple registrants) and mail them to Carol Ann Franklin, 711 Lakeview Dr. Clinton, MS 39056. Feel free to email any questions concerning payment to
cfranklin@clintonpublicschools.com
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Additional Terms
Forms
