PRINT FORM
Please print or type information and mail to address below with your check for payment.
Last Name _____________________________ First Name _________________ IRA# ______________*
Address __________________________________________ Home Phone ( ) ___________________
City _______________________________ Zip __________ Work Phone ( ) ___________________
E-mail ___________________________________________ Fax ( ) __________________________
Pre-registration Fees - Save by Pre-registering
Early Bird Conference Registration (Postmarked by Feb. 12, 2005)
ORA Member $65.00 ____________
ORA Non Member $85.00 ____________
Student Member (Full time student with a valid ID)** $35.00 ____________
( To qualify for student rate, one must be attending higher education
full time carrying 12 hours or more in the spring semester of 2005.)
Full Conference Registration (Postmarked after Feb. 12, 2005)
ORA Member $75.00 ____________
ORA Non Member $95.00 ____________
Student Member (Full time student with a valid ID) ** $45.00 ____________
Total ____________
All registration fees include lunch with author!
Mail to: Conference Chair:
Oklahoma Reading Association Jennie Eddy
2504 Ridgewood Drive (405) 794-7642 (h) (405) 692-5650 (w)
Moore, OK 73160 E-mail: nbcteacher@cox.net
* To join IRA call 1-800-336-READ or go on-line at www.reading.org
** A copy of current student ID must accompany student registration
_______Please check here if, under the Americans with Disabilities Act, you require specific aides or services during ORA's conference.