IMLA Annual Conference

IMLA Conference 2010 Information Page

Individual Or Non Member Registration Form
"A Journey Through the Middle"
Boise Doubletree-Riverside
2900 Chinden Boulevard, Boise, Idaho, 83714
Tel: 1-208-343-1871   Fax: 1-208-344-1079
March 19-20, 2010
Boise, ID


COPY and PRINT THE  FORM BELOW AND SEND BY
FAX or EMAIL or MAIL TO:
Registration Form


Bev Bradford
IMLA Treasurer
P.O. Box 190869
Boise, ID 83719
Email: bev.bradford@gmail.com
or

FAX 1-866-729-4861
 Be sure that all information is correct so that Registration Name Tags will be correct.
..................................................................................................................................
REGISTRANT INFORMATION

LAST NAME:                                                                                     ___      

FIRST NAME:                                                                                         _ __ 

SCHOOL/ORGANIZATION:                                                                       _     

SCHOOL ADDRESS:                                                                             _____ 

CITY:                                                                  ZIP:                           __   

PHONE NUMBER:                                                                   

GROUP REGISTRATION: For Member Only
(Deadline -February 2nd)
Use Group Registration Form

TOTAL AMOUNT DUE
 

TOTAL DUE (See Registration Fees Below): _________________

NUMBER OF ATTENDEES:__________________

REGISTRATION PAYMENT


         Check (Payable to IMLA)


         Official Purchase Order Enclosed #                                                        

Note: Registration includes buffet breakfasts on Friday and Saturday, and lunch on Friday.


INDIVIDUAL  REGISTRATION FEES

MEMBER

 NON-MEMBER

Early Bird  for Members Only
Must be Received by February 2, 2009

$  130

Does Not Apply

General Registration
Received by February 25, 2009

 $  150

$  180

General Registration
 Received after February 25th , and on Site

 $  185

$  200

Students attending  a University with IMLA membership - Must Register through University

$60

Does Not Apply

Please indicate below if you prefer a vegetarian lunch on Friday.

                 I prefer a vegetarian lunch on Friday.


Click here to download form in PDF format.
Individual Registration Form