Pre-Conference Workshop Registration


	CCID 34th Annual Conference

Pre-Conference Workshop

Sunday, February 21, 2010 1:00 to 5:00 PM Registration Fee: $50.00 per participant. Online PRE-REGISTRATION for pre-conference workshop is required. We regret but for workshop planning purposes we cannot accommodate last minute interests, please register early to attend. The last date by which we will accept pre-conference workshop registrations at the CCID office is Monday, February 8, 2010. We thank you for your cooperation. Please stop at the conference registration desk prior to the workshop as you need to receive your conference packet with a workshop pass in order to be admitted to the workshop.
All fields below marked with an asterisk must be completed (no need to fill all of the fields if you have already registered for the entire conference - in such case please indicate your name and email, thank you) Cultural Competency for Educational Leaders (Lee Mun Wah, StirFry Seminars and Consulting) Meeting Room: Waterway 2 I will attend: *
Name:	*
Position:
Institution:	*
Address:	*
City:	*
State:	*
Zip:	*
Country:	*
Phone:	*
Fax:
Email:	*

PAYMENT METHOD :

Checks, Money Orders and Purchase Orders are accepted. PO#:
Make checks payable in US dollars only to: CCID Executive Office
Credit card payment (Visa, Master Card & Discover) can be arranged by calling the CCID Executive
Office at 319.398.7183 or -7622. Calling our office to pay for your registration does not substitute for submitting the online registration.
Mail checks to:
	CCID Executive Office 6301 Kirkwood Blvd. SW Cedar Rapids, Iowa 52404 USA
Advance payment by check or credit card is required as there will be no on-site payments accepted. *We strongly recommend that you PRINT a copy of your workshop registration form for your file.*

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