Keystone State Reading Association

Keystone State Reading Association

Keystone State Reading Association

Forty-Fourth Annual Conference

LITERACY: SHARE THE PASSION

October 27-29, 2011

LANCASTER CONVENTION CENTER – LANCASTER, PENNSYLVANIA

CONFERENCE REGISTRATION FORM

Please print or type.

Name:
Last / First / Name on Badge
Home Address:
Street / City / State / Zip
Home Phone ( ) / E-mail
School District or Employer Name
Group Contact Person (If Applicable):
Phone ( )______/ E-mail______
KSRA Members / Local Council: / KSRA #: / Exp. Date

Full-Time Undergraduate Students must complete the following:

College or University Name / Signature of Professor

Conference Registration Directions (Registration fees and options on reverse side)

  1. Personal or institutional checks, money orders, signed purchase orders, and Visa and MasterCard are accepted. A $30.00 fee will be charged for returned checks.
  2. To qualify for KSRA member rates, you must be a member when you register. The local council name, KSRA membership number, and expiration date must be listed, and the expiration date must be after October 31, 2011. A KSRA membership form can be found in the program and at Groups of 10 or more qualify for the KSRA member rates when all registrations andpayments are received at the same time. Student groups of 50 or more from the same college receive a 10% discount (100 or more = 20% discount) if registered all together by the early date.
  3. Full payment is required with registration. If used, signed Purchase Orders must accompany registrations.
  4. Verification of registration via E-mail will be sent prior to the conference if the early registration is received postmarked by September 30, 2011. Conference registration packet will contain receipt.
  5. Early registration rates apply when registration and payment are postmarked on or before September 30, 2011. After September 30, 2011, there will be on-site registration only with higher rates applied.
  6. Refunds will be granted if written notification is postmarked on or before September 30, 2011. A 20% processing fee will be deducted from registration refunds. Special event and meal fees cannot be refunded.
  7. Hotel reservations must be made directly with the hotel. Lancaster hotel charges include breakfast and dinner, beginning with dinner on the day of arrival and ending with breakfast on the day of departure. Charges also include all applicable taxes and meal gratuities.
  8. On Thursday and Friday, those not registered for the hotel may purchase dinner tickets at the KSRA registration desk until noon.
  9. Check if you require: Vegetarian Meals______Specify Other______
  10. Specify aids or services needed during conference: ______
  11. Mail registration form and payment to: Katherine Mack, 3774 Peach Drive, Danielsville, PA 18038.

Phone: 610-767-1672; E-mail:. For E-mail, write “KSRA” in the subject heading. (OVER)

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