Online Registration Form (for Individual Registration)

Your registration is not complete until you pay either through our PayPal option or by mailing a check to the address listed at the bottom of the form.

Name Tag Information
Last Name: First Name:
 
Middle Initial:
 
Institution: City:
 
State:
 
Contact Information
 
Street address (line 1):
 
Street address (line 2):
 
City:   State: Zip:
 
Daytime Phone: (Enter xxx-xxx-xxxx with no parenthesis)
 
Evening Phone: Email:
 
Fax:

Additional Information

Check here if you have submitted a proposal to present at the conference.

Check here if you are a first-time NCLCA Conference attendee.

Check here if you would be willing to serve as a session moderator.  (You would be responsible for handing out and collecting evaluation forms before and after a presentation, introducing the presenter, and providing any other resources or support needed.)

Check here if you will be attending Thursday's Awards Banquet (this event is included in the fee for the conference).

Check here if you will be attending Friday's Continuing the Conversation (CC) Luncheon.  This event, which is included in the fee for the conference, seats attendees together by interest in order to have conversations during lunch.  It's great fun and a wonderful way to network.

Check here if you are attending the CC Luncheon and are willing to serve as a facilitator.

Check here if you require a vegetarian meal for Thursday's Awards Banquet or Friday's CC Luncheon.

Check here if you require a kosher/halal meal for Thursday's Awards Banquet or Friday's CC Luncheon.

Conference Choices

   
Check here for late/on-site registration: conference fee with NO membership.  To add a membership to your conference fee, you must choose the membership option at the bottom of this form as well as this option. $265.00
   

Check here to attend the conference for one day only.  Please indicate below which day you will attend (Thursday, October 2 or Friday, October 3).

$130.00

Check here if you are a full-time student or a retiree and wish to attend the conference and purchase a membership. 

Note: Students must mail or fax a copy of their student ID to the membership secretary listed below.

 

 $115.00

($85 conference and $35 dues)
Check here if you are a full-time student or a retiree and wish to attend the conference with NO membership.  $85.00

 

Pre- and Post-Conference Institutes and "Lunch With"

(Please note that there are "Combination Deals" offered in the next section if you are interested in attending more than one Pre- or Post-Conference Institute.)

Check here to attend Pre-Conference Institute A: "Help!  I'm a New Learning Center Director" by Alan Craig.  Wednesday, October 1, 8:30am-11:30am.  $50.00
Check here to attend Pre-Conference Institute C: "Learning Centers 2.0" by Lisa D'Adamo-Weinstein and Craig Lamb.  Wednesday, October 1, 8:30am-11:30am.  $50.00
Check here to attend Pre-Conference Institute E: "Current Practices in Learning Center Assistance" by Frank Christ.  Wednesday, October 1, 1:30pm-4:30pm. $50.00
Check here to attend Pre-Conference Institute F: "Tutoring Support through Learning Centers" by Jack Truschel (ATP, Association of Tutoring Professionals), Wednesday, October 1, 1:30pm-4:30pm. $50.00
Check here to attend Pre-Conference Institute G: "Planning Your Submission to the Journal" by Christine Reichert (TLAR editor), Wednesday, October 1, 1:30pm-4:30pm. $50.00
Check here to attend Post-Conference Institute H: "Instructional Applications of Blogs, Wikis, and Second Life" by David Caverly, Saturday, October 4, 8:30am-11:30am. $50.00

Pre- and Post-Conference Institute Combination Deals

Combo Deal #1: check here to attend two conference institutes, any combination of Pre-or Post-Conference.  Please select your two choices below. 

Choose a morning Pre-Con or a Post Con:

AND choose an afternoon Pre-Con or a Post-Con:

 

 $90.00

Combo Deal #2: check here to attend two Pre-Conference Institutes, plus a Post-Conference Institute. 

Choose a morning Pre-Con:

AND choose an afternoon Pre-Con:

AND choose a Post-Con:

 

 $125.00

Luncheon with Dr. Stephen Porter: meal and discussion

Check here to attend this limited-seating luncheon and discussion with Dr. Stephen Porter on Wednesday, October 1 from 11:45am-1:15pm $25.00

Membership Purchase

(if not part of your registration package)

Check here to purchase an NCLCA Membership.    $50.

Membership Type:

Renewal or New Member:

Have you earned LCLC?

Are you interested in serving on a committee?

Total Registration Fee

Please enter your total amount here:

*Note: you must pay through PayPal with a credit or debit card OR mail a check to the Membership Secretary listed below.  Your registration will not be complete until you have paid your fees either through PayPal or with a mailed check.  Make your check payable to NCLCA.  Our tax ID number is 391 641 695.

Check here if you are paying through PayPal

Check here if you are paying with a check or money order sent through the mail.  Please send to the address below:

Tammy Pratt
Assessment and Learning Center
Carnegie Building Room 200
650 Parrington Oval
Norman, OK 73019

(405) 325-4336
tpratt@ou.edu
 
Conference Refund Policy
 
NCLCA will consider refund requests until September 19, 2007 (7 days prior to the start of the conference).  Please request your refund in writing from the NCLCA Vice President David Reedy (reedy.d@rhodesstate.edu).  There will be a $25 processing charge.  From 7 days to the start of the conference, NCLCA will consider refund requests only in situations such as serious personal illness or a death in the family.  An additional $25 processing charge applies for unrecoverable food costs.
 

Your registration will not be received until you click "Submit" below.

WAIT!

Before you submit, look over your choices carefully to check for any errors.  Print it for your own records.  Having a print-out will help you as you use the PayPal option to pay, or, alternatively, as you write a check to mail.