MVC 2017 Registration Form
You can use this form for individual registrations for the 2017 Mt. Vernon Conference, October 27, 2017. For more information go to
If you are a school district, wanting to register multiple staff members, please contact Julie -
Attendee's Name:
Your answer
Attendee's IEIN (Illinois Educator Identification Number)
Your answer
Email Address:
Your answer
School District or Facility Name
Your answer
School or Facility Phone Number (including area code)
Your answer
Billing Street Address
Your answer
City/State/Zip Code
Your answer
If an interpreter is needed, please indicate language here:
Your answer
Conference Registration:
Please select the registration appropriate to the attendee.
Registration payment information
Registration payments may be mailed to:
Ron Daniels, Regional Supt. of Schools
Attn: Mt. Vernon Conference
1710 Broadway St.
Mt. Vernon, IL 62864
Professional Development "Clock Hour" information
Clock hour labels, formerly known as CPDU labels, will be provided at the end of each session that meets the ISBE professional development requirements. Labels are to be placed on the clock hour form located in the conference program. There will be sign in sheets that require attendee signatures at some sessions. For further information contact or call our office (618) 244-8040
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