On-Site Registration Only After June 20, 2017

Conference Registration June 27 & 28, 2017

Register by April 1, 2017 to receive Pre-Registration Discounts. On-Site registration only after June 20, 2017.

Last Name: First Name: Address: City: State: Zip: Email: Home Phone: ( ) Employer: Work Phone: ( ) Local Council:

Online registration is available. Click or visit the following link : http://www.eventbrite.com/e/2017-iowa-reading-association-conference- dive-into-reading-tickets-26742539656 A transaction fee will be assessed for online registration.

Please forward your completed registration form to: Iowa Reading Association, P.O. Box 16, Ossian, Iowa 52161 or scan and email to: mailto:[email protected]. Write "Online Registration" over the Total Amount Due.

Full Conference Registration Before 4/1 After 4/1 Before 4/1 After 4/1 Member $150 $175 Full Time Student $30 $35 Non-Member $190 $215 Retired Teacher $45 $55

Registration Subtotal:

Meals: All meals include sides, salads, dinner roll, iced tea, milk and coffee. Tuesday’s lunch also includes a brownie. Check meal requests below:

Tuesday Luncheon: Grilled Hamburger Buffet $12.75 Tuesday Evening Awards Banquet: Pecan Parmesan Crusted Chicken Breast $19.25 Wednesday Luncheon: Grilled Chicken Sandwich Buffet $12.75

Meal Subtotal: Total Amount Due:

Special dietary meals are available upon request. Please contact Clark Goltz, Executive Director, for special meal requests.

Group Registration: Group discounts are available; however, they are not applicable with online registrations. Contact Clark Goltz, Executive Director, by phone or email for details. No refunds will be given due to situations beyond our control (i.e. inclement weather conditions). No refunds after June 1, 2017.

Coffee, hot tea, juice, water, rolls, quick breads, lemonade, iced tea, and assorted cookies will be provided throughout the day for free. Pop and vending machines are available on site as well. Phone 563-380-1999 if you have questions. Mail this form with a check or institutional purchase order. No credit card payments. Checks made out to the Iowa Reading Association and sent to:

Clark Goltz P.O. Box 16 Ossian, Iowa 52161 i o w a r e ad i ng @gmail. c o m

Credit will be offered through Northwestern College (graduate - $110), Viterbo University (graduate - $110), and through Heartland AEA 11 (renewal - $35).

For Hotel Accommodations, contact the Gateway Hotel @ 515-292-8600, the Best Western University Park Inn and Suites at 515-296- 2500 or the hotel of your choice in Ames, Iowa.