<p> Computers and Their Impact on State Assessment: Recent History and Predictions for the Future</p><p>REGISTRATION FORM </p><p>October 18-19, 2010 $125 Registration Fee ($62.50 for students)</p><p>Name: ______Title: ______Agency/Organization: ______Street Address: ______City: ______State: ______Zip Code: ______Phone: ______Ext.: ______Fax: ______Email: ______</p><p>Form of Payment: 1) Check Number: ______2) Purchase Order Number: ______3) Credit Card Type:  Visa  MasterCard  American Express  Discover Number: ______Expiration Date: ______4) Cardholder (print name on credit card): ______</p><p>Registration Policies:  A check or company purchase order made payable to the University of Maryland [tax ID number: 52-6002-033] or credit authorization must accompany your registration.</p><p> Your registration fee covers the cost of all course materials - breakfast both days, refreshments at breaks and lunch on the first day. Participants are responsible for their own lodging, other meals, and parking.</p><p> Registration is on a first-come, first-serve basis and is limited to the first 150 paid registrants.</p><p> Early registration is advised, as the maximum enrollment limits cannot be exceeded.</p><p> A full time student (verified by signature below) can register at half price. 1. Department Head Signature: ______2. Print Name of Department Head: ______3. Institution & Department: ______</p><p>Cancellation Policy:  The University of Maryland reserves the right to cancel an event given insufficient registration and to refund registration fees.</p><p> Should you find it necessary to cancel your registration, your fee, less $50.00, will be refunded if notice of cancellation is received at least ten days prior to the start of the session.</p><p> Weather Policy: Official closures and delays due to inclement weather are announced on the campus website and snow phone line (301-405-SNOW) as well as local radio and TV stations. In case of cancellation, full refunds will be made to registrants and the cancelled even will be rescheduled. Contact:  Email or fax your registration to: Ms. Elizabeth Lintz, [email protected] EDMS Seminar and Training Center Phone: (301) 405-3629 FAX: (301) 314-9245</p>