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OKAA Annual School-Age Conference

OKAA Annual School-Age Conference
Moore/Norman Technology Center
13301 S. Penn, OKC, 73170
Saturday, September 20, 2008

Please complete one form for EACH conference attendee.
All fields marked with an asterisk (*) are required.

ATTENDEE INFORMATION
Today's Date:
*First Name:
*Last Name:
*Organization/Company:
*Position:
*Address:
*City:
*State:
*Zip Code:
*Work Phone:
Cell Phone:
FAX:
*E-Mail:


CONFERENCE INFORMATION
Conference Fee: $75.00 / per Attendee
(Regular Price) VALID FROM 7/1/2008 - 8/31/2008

$85.00 / per Attendee
(Regular Price + Late Fee) VALID FROM 9/1/2008 - 9/18/2008
Conference Discounts: (Please mark all that apply.)
I HAVE A PAID 2008 OKAA Membership   $-10.00
I HAVE A FREE 2008 OKAA Membership   $ 0.00
I AM USING A DHS Voucher:                   $-25.00
*DHS License #
(REQUIRED if using voucher)
Total Due: $
Payment Method: Check/Money Order
Purchase Order
*PO #
(REQUIRED if using a PO)

Amount subject to review and verification by OKAA.

Please remit your payment payable to “OKAA” within 14 days including registrant’s name and organization/company to:

Oklahoma AfterSchool Association
Post Office Box  1465
Newcastle, OK  73065