Oregon Association of Student Councils

OASC Fall Conference

Registration Form

TO BE COMPLETED BY ADVISOR ONLY!

Registration Deadline: Friday, October 22, 2010

Please fill out this form and submit it online or print it and send with payment to:

OASC
707 13th Street SE, Suite 100
Salem, OR, 97301-4035

School Name:
School Address:
City:
Zip:
School Phone:
Name of Advisor:
Home Phone number with area code:
E-mail Address:
Advisor who will receive conference packet at registration:
Conference Fees:

OASC Member Schools:	Non-Member Schools:
$56.00 per person if registered by October 22 Deadline $66.00 per person if registered after October 22 Deadline	$76.00 per person if registered by October 22 Deadline $86.00 per person if registered after October 22 Deadline
Registration includes conference materials and Monday's Continental Breakfast & Luncheon PLEASE NOTE: You will be charged $20.00 for each no-show to cover our costs unless you call by Tuesday, November 2, 2010.

Schools may bring 15 people maximum (including adults)

Number of Students attending conference @ $ =

Number of Adults/Advisors attending conference @ $ =
(pay same amount as students)

Additional Students IF PRESENTING A BREAKOUT SESSION or IDEA SHARE BREAKOUT SESSION (5 extra allowed) @ $ =

2010-11 Member Dues @ $55.00 (please enclose membership form)

TOTAL AMOUNT DUE:

Sending Payment
Bill School, PO#

If you have a Purchase Order number
and wish to be invoiced, you may submit this form online.

Please indicate whether or not you will be staying for Monday luncheon (which is included in registration)
* If you sign up for the luncheon, please plan to stay for the duration.

We will be staying for the luncheon.

LUNCHEON CHOICE (indicate numbers) Carnivore(s) Vegetarian

We will not be staying for the luncheon.

To be signed by advisor is responsible for students attending the conference: I will be responsibile for the conduct of students from my school who will be attending the Fall Conference. I will thoroughly review the rules of conduct and expectations with these students. Advisor Signature
Security Code:
Please enter the security code you see above in this box:

If you would like to send payment with your membership form, please print this form and mail to the address below.

Mail to: OASC 707 13th Street SE, Suite 100 Salem, OR 97301-4035

Questions? Contact Sara Nilles, Program Director
or call 503-480-7206.

OASC Fall Conference

TO BE COMPLETED BY ADVISOR ONLY!

Registration Deadline: Friday, October 22, 2010

Conference Fees:

Schools may bring 15 people maximum (including adults)