Page 11 - 2022- 49.4
P. 11

REGISTER TODAY – www.PLSeducation.org    CLSA-NALS CONFERENCE 2023
                                           REGISTRATION





        ______________________________________________________________________________________________________________________________________________________
        NAME  (First/Last)                                                                                                               NICKNAME or NAME (as you wish it to appear on your badge)
        ______________________________________________________________________________________________________________________________________________________
        COMPANY
        ______________________________________________________________________________________________________________________________________________________
        ADDRESS
        ______________________________________________________________________________________________________________________________________________________
        CITY                                                                                                                                                         STATE                                         ZIP
 THE THE  C L S A - N A L S  C O N F E R E N C E  ______________________________________________________________________________________________________________________________________________________
 C L S A - N A L S  C O N F E R E N C E
        PHONE                                                                                                    FAX
        ______________________________________________________________________________________________________________________________________________________
 G R E A T E S T  ______________________________________________________________________________________________________________________________________________________
 G R E A T E S T
        E-MAIL
        MEMBER #  (Indicate: CLSA OR NALS)
        ______________________________________________________________________________________________________________________________________________________
        SPOUSE/GUEST (if attending – see Spouse/Significant Other Registration below)
        MEMBER REGISTRATION
                                                                     OPTIONAL ACTIVITIES
                                      BY FEB 26  AFTER FEB 26  AMOUNT

                                                                                                               AMOUNT
                                                                                                    ____@ $55      $________
                                                                     Extra Sunday Lunch Ticket
        PreConference Workshops
        PreConference Workshops: Saturday (all day).
                                                                     Extra Sunday Icebreaker Ticket
                                                                                                    ____@ $55      $________
                                                 $475
                                                         $________
        Conference Only
                                       $425
        Conference Only Registration: Sunday through Tuesday. $250   $300   $________  Extra Monday Lunch Ticket   ____@ $55      $________
                                                                     Extra Monday Auction/Dinner Ticket
                                                                                                    ____@ $75      $________
        Includes Sunday, Monday and Tuesday Luncheons, Sunday IceBreaker Reception
        and Monday Scholarship Auction.                              Student Assistance Donation (Suggested Donation $20)          $________
        Does not include Pre-Conference Workshops on Saturday (all day).
                                                                     NALS 50th Anniversary Gala (Saturday)  ____@ $55      $________
        Conference & PreConference Workshop $525   $575   $________
        Full Conference Registration: Saturday through Tuesday.      Not included in conference registration.
        Includes all preconference workshops and conference registration.
        Conference One Day             $225      $275    $________   PAYMENT INFORMATION
        Select Day:  Sunday   Monday   Tuesday
                                                                     Total Enclosed $____________
        NON-MEMBER REGISTRATION
                                      BY FEB 26  AFTER FEB 26  AMOUNT   Check Enclosed (Checks payable to WRSC Conference)
        PreConference Workshops        $350      $400    $________   Charge to:   Visa    MasterCard
 Lorem ipsum  PreConference Workshops: Saturday (all day).
                                                                     ____________________________________________________________
        Conference Only                $525      $575    $________   CARDHOLDER NAME
        Conference Only Registration: Sunday through Tuesday.
        Includes Sunday, Monday and Tuesday Luncheons, Sunday IceBreaker Reception   ____________________________________________________________
        and Monday Scholarship Auction.                              CARD #
        Does not include Pre-Conference Workshops on Saturday (all day).
                                                                     ____________________________________________________________
        Conference & PreConference Workshop $625   $675   $________  EXP. DATE                                                               CVV#
        Full Conference Registration: Saturday through Tuesday.
        Includes all preconference workshops and conference registration.  ____________________________________________________________
                                                                     BILLING ZIP CODE
        Conference One Day             $325      $375    $________   ____________________________________________________________
        Select Day:  Sunday   Monday   Tuesday                    AUTHORIZED SIGNATURE
        OTHER REGISTRATION
        Spouse/Significant Other Registration    $275    $________   MAIL TO:                 FAX TO:    (707) 578-4406
        Includes badge, entrance to Exhibit Hall, Sunday Icebreaker Reception,   CLSA-NALS Conference Office
        Sunday and Monday Lunch and Monday Scholarship Auction.      526 South E Street       QUESTIONS?

        Full-time Student Registration           $275    $________   Santa Rosa, CA 95404     (888) 994-3510
        Must attach current student ID.                                                       conference@plseducation.org
 M A R C H  2 5 - 2 8,  2 0 2 3  S I L V E R   L E G A C Y  Sunday, and MondayLuncheons, Sunday IceBreaker Reception    CANCELLATIONS: - Cancel by February 26, 2023 to receive a
 S I L V E R   L E G A C Y
 M A R C H  2 5 - 2 8,  2 0 2 3
        Includes Conference Registration (Sunday through Tuesday),
        and Monday Scholarship Auction.
        Does not include PreConference Workshops on Saturday (all day).
                                                                     refund, less a $50 cancellation fee.  After February 26, 2023 no
                                                                     refund will be available but substitutions can be made.  Cancellations
                                                                     must be made in writing by emailing conference@PLSeducation.org
 R E N O,  N E V A D A                                               IMPORTANT - Visit Conference website, PLSeducation.org for
 R E N O,  N E V A D A
                                                                     other important disclaimers and information.
                           Register Online at: www.PLSeducation.org
   6   7   8   9   10   11   12   13   14   15   16