You are welcome to register online at www.oklahomacec.com

BASIC INFORMATION

First Name: Last Name: School/Agency:

Address: City State Zip

Work Phone: Home Phone: Email:

CEC Membership #: Special Accommodations:

CONFERENCE FEE

Which day's conference will you attend?

Are you filling out this form before 4:00pm Jan. 25, 2010?

YOUR CONFRENCE FEE IS:

LUNCH

I will be eating lunch at the conference on

Special dietary request (We will do our best to accommodate your identified needs.):
Nothing special
Vegetarian
Other: Please specify

METHOD OF PAYMENT (Make payable to OKCEC.)

Purchase Order #: will be mailed. (OKCEC FEDERAL ID # 73-1208142)
Purchase Order #: that will be presented at conference.
Personal check #: will be mailed.
Pay online via PayPal
I have enclosed an additional donation $ to sponsor a college student who would like to attend the conference.

CONFERENCE FEES TABLE
Conference fees include lunch and snacks. Cancellations must be received on or before Jan. 25 at 4:00 p.m.; otherwise, payment is required even if participant is unable to attend.	* Reservations on or before 4 p.m. January 25, 2010			* Reservations after 4 p.m. January 25, 2010
	Full Conference (2 full days)	Tuesday Only (1 full day)	Wednesday Only (1 full day)	Full Conference (2 full days)	Tuesday Only (1 full day)	Wednesday Only (1 full day)
	$50	$30	$30	$60	$35	$35

Register online at www.oklahomacec.org

Mail registrations to: OKCEC, c/o Staci Vollmer, 10500 East Lindsey Street, Norman, OK 73026-8242

FAX registrations to (405) 329-6342: OKCEC, Attn: Staci Vollmer

Email registrations to oklahoma@oklahomacec.com: OKCEC, Attn: Staci Vollmer

For more information contact: Staci Vollmer at (405) 535-2993

Co-sponsored by the Oklahoma State Department of Education (OSDE), Special Education Services

CONFERENCE FEES TABLE