Registration Form for the
 Oklahoma Division of Student Assistance
Annual Conference
March 31 - April 2, 2008 

Call (800)228-9290 to make your reservation (reference - ODSA Conference).

Room Rates - $92.00 / night

Purchase Orders are accepted.

*If you plan to utilize tax-exempt status, you must bring a copy of your

tax-exemption status and FIEN number on program letterhead. 

FEI#: 86-0803814

Please register all program staff who will be attending the conference.
If you are paying by Purchase Order, be sure to include your PO Number when you register!

1. Name:    Title/Position: 
    Date Employment with TRIO Began:    LPC: Yes No   NCC:  Yes No

    Shirt Gender Mens Womens   Shirt Size X-Small Small Medium Large X-Large XX-Large XXX-Large 4X-Large 5X-Large 6X-Large
 

2. Name:    Title/Position: 
    Date Employment with TRIO Began:    LPC: Yes No   NCC:  Yes No

    Shirt Gender Mens Womens   Shirt Size X-Small Small Medium Large X-Large XX-Large XXX-Large 4X-Large 5X-Large 6X-Large
 

3. Name:    Title/Position: 
    Date Employment with TRIO Began:    LPC: Yes No   NCC:  Yes No
    Shirt Gender Mens Womens   Shirt Size X-Small Small Medium Large X-Large XX-Large XXX-Large 4X-Large 5X-Large 6X-Large

4. Name:    Title/Position: 
    Date Employment with TRIO Began:    LPC: Yes No   NCC:  Yes No
    Shirt Gender Mens Womens   Shirt Size X-Small Small Medium Large X-Large XX-Large XXX-Large 4X-Large 5X-Large 6X-Large

5. Name:    Title/Position: 
    Date Employment with TRIO Began:    LPC: Yes No   NCC:  Yes No
    Shirt Gender Mens Womens   Shirt Size X-Small Small Medium Large X-Large XX-Large XXX-Large 4X-Large 5X-Large 6X-Large

6. Name:    Title/Position: 
    Date Employment with TRIO Began:    LPC: Yes No   NCC:  Yes No
    Shirt Gender Mens Womens   Shirt Size X-Small Small Medium Large X-Large XX-Large XXX-Large 4X-Large 5X-Large 6X-Large

7. Name:    Title/Position: 
    Date Employment with TRIO Began:    LPC: Yes No   NCC:  Yes No
    Shirt Gender Mens Womens   Shirt Size X-Small Small Medium Large X-Large XX-Large XXX-Large 4X-Large 5X-Large 6X-Large

Contact Name: 
Institution: 
Address: 
City:    State:    Zip: 
Telephone:    Fax: 
E-Mail:    Program Website: 

Please mark with which program you are affiliated:  (To mark more than one, hold down the alt key.)

  EOC ETS McNair SSS UB UBMS VUB
 

Early Bird (by Feb. 28th) Registration - $130.00/person

Late Registration (After Feb. 28th) - $150.00/person

             [does not include a conference shirt or materials]

REGISTRATION DEADLINE -- MARCH 7TH, 2008

Method of Payment: 
Check  Purchase Order    PO# 
                             

SPECIAL SERVICES REQUIRED:  Please give a brief description of your needs (vegetarian meals,

                                                    special assistance, special room accommodations, etc.)

*REFUND POLICY

Refunds of registration fees will be considered only upon written request. For a full refund requests must be received or postmarked thirty days before the conference start date. For a 50% refund, requests must be received or postmarked ten days before the conference start date. No refunds will be issued after that date.

Membership dues of $30 will be accepted on site.  Please remember that dues cannot be paid from federal funds. 

For questions regarding on-line registration, please contact Tony Lehrling at tlehrling@sosu.edu, or 580-745-2719.
For questions regarding payment, please contact Francie Moss at mossv@osuokc.edu, or 405-945-8626.
For questions regarding conference information, please contact Deborah Binkley-Jackson at dbjackson@ou.edu, or 405-325-2143.