2009 MEMO Fall Conference Registration

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2009 MEMO Fall Conference
School 2.0: Get Connected!

October 1-3, 2009
Mayo Civic Center - Rochester MN

Contact Information

Name badge information

First name *

Last name *

School/organization *

Address (please include school/org name if this is a work address)

Street Address

Address continued

City

State

Zip

Address is for my WorkHome

Other contact

Email address *

Daytime telephone

Other

If you are a lead presenter or conference committee member, please indicate that here (please specify presenter, committee member, etc). You will be refunded the appropriate amount after the conference.

Payment information

Payment options:

1. Mail your check or money order after you register online. (Note: Please be sure check indicates whom the payment is for, especially if your district is paying!)

2. Enter your school's purchase order number and indicate whether MEMO should invoice your school or your district headquarters.

3. NEW!! Pay with a credit card using PayPal! Click the submit button below, review your registration and click the confirm button on the next page. You will then be directed to the "pay now" page where you can link to PayPal and pay using a credit card.

Amount owed (please double-check for accuracy!)

Payment method (skip this and submit registration to pay with PayPal) Check or money order
School purchase order

Purchase order number:

Please invoice my
School/Organization
District Headquarters

Payment (in U.S. funds only) should be payable to MEMO and sent by 9/20 to:

Deanna Sylte, Admin. Asst.
MEMO
PO Box 130555
Roseville, MN 55113

Phone/fax: 651/771-8672
admin@memoweb.org

Final payment or school purchase order must be presented at registration for all attendees who have not submitted them in advance.

Notify us of your cancellation on or before September 20, 2009. Personal substitutions via written notice are accepted for registrants unable to attend. After September 25 a $25 handling fee will be assessed. Refunds cannot be granted after the conference begins.

Make sure your form is submitted!

1. Click "submit" below. You will be directed to a page to review your choices.

2. Click the "confirm" button at the bottom of the review page to submit your registration.

3. After your form is submitted you will hve the option to pay via a PayPal "pay now" button. If you choose not to do so, simply close your browser window.

If you do not receive a confirmation email showing your registration choices, contact the MEMO office at admin@memoweb.org.

** Office Use Only - DO NOT USE **

	PO #:	Amt:	Issuer:	Ck #:	Date:	Amount:

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