Dr.    Mr.    Ms.    Mrs.

First Name:       MI: 

Last Name:   

Email:   

Mailing Address:   

City:   

State:   

Zip:   

Home Telephone Number:   

Cell Telephone Number:                  

Employer/Institution:   

School/Affiliation: 

Grade Level (if applicable): 

Work Telephone Number:   

Fax Number:   

Please check the days for which you are registering:

Friday, February 26
Saturday, February 27

Pre-registration before February 19, 2010 - Please click only one of the following options below.
$70.00 for one day      
$100.00 for two days         

From February 20-25, registration fees will increase to $100.00 for one day and $175.00 for two days.   On-site registration fees are $100 per day. 

All checks and money orders should be made payable to "UNC Charlotte."

After clicking "Submit" below, please mail a copy of your confirmation form with your payment to:

Office of Educational Outreach
Attn:  Julia Dagenhart
University of North Carolina at Charlotte
9201 University City Blvd.
Charlotte, NC  28223-0001
Telephone:  (704) 687-8998
Fax:  (704) 687-6289
Email:  jpdagenh@uncc.edu 

Please print the confirmation page after clicking the "Submit" button below.  Please bring a copy of the confirmation page to the registration table at the the conference.  Thank you!