<p> INVEST IN READING CONFERENCE REGISTRATION FORM For the 61st West Virginia Reading Association Conference November 17-18, 2016 The Greenbrier, White Sulphur Springs, WV Pre-registration using this form with payment will be accepted until October 15, 2016. Mail your completed form to: WVRA Conference Registration P.O. Box 382 Craigsville, WV 26205 You can also register online using a purchase order or credit card at regonline.com/investinreading </p><p>For any additional questions, contact Aleda Hileman at [email protected]</p><p>PLEASE PRINT – ALL FIELDS REQUIRED-COMPLETE ONE FORM FOR EACH REGISTRANT Last Name First Name Date</p><p>Street or Route and Box Number Home Phone</p><p>City State Zip Email Address</p><p>Work Phone Position</p><p>Local Council (County) County of Residence IRA Member (Circle One) Yes No</p><p>CONFERENCE INFORMATION AND FEES Please check applicable fees if using this form. For credit cards only, use on line form at www.regonline.com/investinreading Super Saver Pre-Registration (postmarked by Oct. 15, 2016) $100.00 Use online site to register Online www.regonline.com/investinreading (before Oct.15, 2016) $110.00 Regular Registration (after Oct. 15) and at the Conference $160.00 Super Saver Student Pre-Registration (postmarked by Oct. 15th ) $40.00 Student Regular Registration and at the Conference (After Oct.15) $50.00 Author Luncheon-Thursday-TBA $45.00 Author Luncheon – Friday - TBA $45.00 TOTAL Please note: Membership is included in the registration fee. METHOD OF PAYMENT No Purchase Orders can be accepted after September 30, 2016. Purchase Order (Must accompany this form) PO# ______Amount $______Purchase Order issued by: Name ______Address______Full Payment of Purchase Order must be received by October 30, 2016 </p><p>NO CREDIT CAN BE EXTENDED Personal Check/Money Order # ______Amount $ ______County/School Check # ______Amount $ ______Make Checks/Purchase Orders for the total amount payable to the West Virginia Reading Association </p><p>REFUND POLICY: APPLICATIONS FOR REFUNDS MUST BE RECEIVED IN WRITING BY OCTOBER 30, 2016. REFUNDS DUE TO INCLEMENT WEATHER CANNOT BE ISSUED. THERE WILL BE A PROCESSING CHARGE OF $20.00 FOR ALL REFUNDS.</p>