Oregon Association of Student Councils

Registration Form

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:
Early-Bird Registration Deadline: Wednesday, April 20, 2011 Conference Fees:

OASC Member Schools:	Non-Member Schools:
$58.00 per person if registered by April 20 Deadline $63.00 per person if registered after April 20 Deadline	$68.00 per person if registered by April 20 Deadline $73.00 per person if registered after April 20 Deadline
A cancellation fee of $25 per no-show will apply. To avoid this fee, please update your final numbers with us before April 22, 2011. We need to have accurate numbers because of the dinner banquet. Thanks! Registration includes speakers, workshops, handouts and the first ever dinner banquet!

Number of Students attending conference @ $ =

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

Dinner choices (please indicate how many for each): Meat: Vegetarian:

Please provide one adult for every 10 students
ADULT SUPERVISION IS REQUIRED!

ADVISOR COMMENTS - please use this space to indicate if you have included SEC in your count or any other needs:

2011-12 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.

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.