Please fill out one form for each registrant. Thank You!

Full Name

Address

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Zip Code

E-mail Address

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Phone

Institutional Affiliation

SOTA Member AIGA Member (Other)    Other:

Do not include my email address in the list of registrants.

Do not include my street address in the list of registrants.

I will attend the Educators Workshop

I will attend the Wayzgoose Conference

Total Due

$75 Educators Workshop Fee $150 Wayzgoose Conference Fee $200 Educators Workshop and Wayzgoose Conference Fee

Payment Method

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Comments / Questions:

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