Payment Form

(printable pdf version available for download below)

29th Annual DuPage Valley
 
SOCIAL STUDIES CONFERENCE
 
Friday, February 27, 2015 
 
Only one form per school please
 

LOCATION:              WHEATON WARRENVILLE SOUTH HIGH SCHOOL

                                  

 

COST:                       $40 per teacher

           

PAYABLE TO:         WHEATON NORTH HIGH SCHOOL

 

DUE BY:                   Wednesday, February 4, 2015

                                    Due to space constraints, registrations received after this
                                    date will not be accepted. 
                                    There will not be on-site registration.

 

MAIL TO:                   Please note: check is sent to Wheaton North and
                                    the conference is at Wheaton Warrenville South.
                                   
                                    Dan Korntheuer

                                    Wheaton North High School

                                    701 W. Thomas

                                    Wheaton, IL  60187

                                    (630) 784-7300 x 8459

                                    Fax (630) 682-2158 -you may fax form without
                                    check to meet deadline
 
1. Teachers register online at https://sites.google.com/site/dupagevalleyssc/
a. Each teacher needs to complete the online registration.
b. They will receive a confirmation email which needs to be saved as proof of registration.
c. Registrations closes on February 6th.  There will not be any on-site registration.
2. Checks are due by Wednesday, February 4, 2015.
3. Cost is $40 per Teacher.
4. This payment form must be sent in only AFTER ALL teachers from the school are registered.  ONLY ONE FORM PER SCHOOL.  The check, made payable to Wheaton North, MUST accompany this form.  Send to address above.

                                                                                                                                                             

School/Building Name:                                                                             
District #:               

 

Department Chairman/Contact Person:                                                                                                         

 (this is the person who will receive the email confirmation)

 

Number of teachers registered from the school____________
                                  

 

Address:                                                                                                     

 
 
 
 
 

City:                                                                                      Zip:                          

 

Phone Number:                                                                                (School)  
                                                                                                              (Home)
 

Email:                                                                                                                             

 

Online registration completed?  Yes    No    

If not, please go to http://www.formstack.com/forms/?995296-RAzgxLa8sG

 

ĉ
Dan Korntheuer,
Dec 9, 2014, 11:25 AM
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