2018 Breakout with Iowa Family and Consumer Sciences Educators Annual Conference Registration Form
Please complete all questions. PRINT a copy for your personal records before submitting this form. Send payment and a copy of this form to: Kristie Kuhse, IFCSE Conference Coordinator, 216 Elm Street, Waverly, IA 50677.

REFUNDS: Full refunds made prior to June 20, 2018 in writing to Conference Coordinator minus $30 IFCSE/IACTE Membership PLUS $25.00 handling fee. After July 10, 2018, no refunds will be issued.

Email address *
First Name: *
Your answer
Last Name: *
Your answer
School District/Organization: *
Your answer
School District/Organization Address: *
Your answer
School/Organization City: *
Your answer
School/Organization Zip Code: *
Your answer
Best Phone Number to Reach You: *
Your answer
AEA: *
Work/school Email: *
Your answer
Home/Summer Email: *
Your answer
Years as and FCS Professional: *
First time attending this conference: *
Conference Registration Options (Online Registration and payment received PRIOR to July 10, 2018):
LATE Conference Registration Options-(Online Registration and payment received AFTER July 10, 2018)
Monday Afternoon Tour Options: Please select one option. Space is limited and will be filled first come first serve. Transportation not provided. Carpooling encouraged. *
Special Dietary Needs: *
Your answer
The Conference Gift is a t-shirt "FCS Without It Adulting is Hard." Select your size. *
Do you need an invoice? List Purchase Order Number from your school.
Your answer
School Business Manager/Supervisor Email: *
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of WSR Schools. Report Abuse - Terms of Service - Additional Terms