WACA Conference Registration w/ Purchase Order

Name *

School *

School Address

Street Address

Address continued

City

State

Zip

Phone #: *

E-mail Address *

WACA Area * Area 1 (Island, Whatcom, San Juan, Snohomish)Area 2 (King)Area 3 (Pierce)Area 4 (Pacific, Lewis, Wahkiakum, Cowlitz, Clark, Skamania)Area 5 (Okanagan, Chelan, Douglas, Grant, Kittitas)Area 6 (Yakima, Klickitat)Area 7 (Spokane, Ferry, Stevens, Pend Oreille, Lincoln)Area 8 (Adams, Benton, Franklin, Walla Walla, Columbia, Garfield, Whitman, Asotin)Area 9 (Kitsap, Clallam, Jefferson, Grays Harbor, Mason, Thurston) WACA areas are divided by county. If you do not know your area, find your county.

Is this your first WACA conference? * yesno

T-shirt size

Grade level you work with * high schoolmiddle levelelementary

Optional Pre-Conference Session * No, I am not attending the pre-conferenceASB Law (Marty Fortin)Leadership Education (Susan Fortin)Servant Leadership (John Norlin) Please indicate your preference about the Pre-Conference session. The Pre-Conference cost is $30.

Conference Registration (Choose one) * Conference only--$340Conference & Pre-conf (includes lunch)--$415

Purchase Order Information

Purchase Order Type * Building PODistrict Office PO

Building or District Issuing PO *

Building or District Address (including ZIP code) *

Building or District Phone #: *

Purchase Order Number *