PDF Registration Form - Connections Project
Connections Conference 2015 Rigorous Academic Career & Technical Education The Connections Conference is clearly focused on new and exciting teaching practices in all discipline areas. It features teachers, counselors and other educators from Illinois and around the United States sharing innovative programs and strategies that have been successful in their schools. Conference goals are to provide sessions for attendees to grow professionally, to showcase exemplary programs, and to support school improvement strategies associated with the High Schools That Work initiative. Conference Features Offers over 100 prac oner‐based sessions in a two day conference format Highlights best prac ces from middle through postsecondary educa on Addresses the needs of teachers/instructors, administrators, and counselors Focuses on curriculum development and instruc onal methods Illustrates how major local, statewide, and na onal educa onal ini a ves can be connected Conference Informa on Dates Wednesday, March 25, 2015 & Thursday, March 26, 2015 Loca on Pheasant Run Resort 4051 E Main Street St. Charles, IL 60174 Phone: 630‐584‐6300 Conference Offerings Speakers Featured Presenta ons Breakout 1‐hour Sessions Deep Dive 2‐hour Sessions Professional Development Hours (formerly known as CPDUs) Evening Networking Social Keynote For More Informa on Details regarding registra on, presenta ons, and keynote/featured speakers will be available on the website at www.connec onsproject.illinoisstate.edu Early Registration Deadline is February 16, 2015 Technical Assistance for Rigorous Academic and Career Technical Educa on Project (Connec ons Project), Illinois State University, Campus Box 1600, Normal IL 61790‐1600, Phone: 309‐438‐5185, Fax: 309‐438‐3211. Visit us on the web at www.connec onsproject.illinoisstate.edu. Conference sponsors: Illinois State Board of Educa on & Illinois State University. Connections Conference 2015 Registration Registra on fees Name badge informa on (Print clearly) Registra ons received without a check or credit card informa on will not be processed. Purchase orders will be allowed ONLY for group registra on of 10 or more people with an official purchase order a ached. (A endees only ‐ No presenters*) First Name Last Name I plan to a end: Ins tu on/Company Early Registra on ‐ Postmarked by February 16, 2015 Full Two Day Conference** $ 190 $______ Single Day, March 25th $ 115 $______ Single Day, March 26th $ 90 $______ Mailing Address City State Zip Telephone ( Fax ( Regular Registra on ‐ Begins February 17, 2015 Full Two Day Conference** $ 210 Single Day, March 25th $ 135 Single Day, March 26th $ 110 ) Ext. Total enclosed/charged ) $_______________ **Two day registra ons are meant to be used by one person: Any person a ending only one day must use a single day op on. (Two day registra ons can not be shared between two people.) E‐mail What posi on best describes your role? Administrator Guidance Counselor $______ $______ $______ Faculty/ Teacher Methods of payment with Registra on Check enclosed, payable to Illinois State University VISA MasterCard Discover American Express What levels apply to your responsibility? (select all that apply) Elementary Middle Secondary Postsecondary Account number Expira on date Subject areas: (select all that apply) Agriculture Business English FACS Health Sciences Math Science Special Ed TE & E Other_________________ How would you categorize your school community? (select all that apply) Rural Suburban Urban Have you a ended a Connec ons Conference before? Yes No Cardholder's signature I am registering a group of 10 or more people and have enclosed an official purchase order to cover the group’s registra on. Easy ways to register: By check, credit card or purchase order Special needs Please indicate any special needs below: Sign language interpreter Assistance because of visual impairments Wheelchair accessibility Vegetarian meal Gluten Free meal Other_____________________________ Mail this completed form and fees to: Illinois State University Connec ons Conference 2015 A endee Registra on Campus Box 8610 Normal IL 61790‐8610 By credit card Fax this completed form to: (309) 438‐5364 Register on‐line at: www.connec onsproject.illinoisstate.edu Register by phone: Call (800) 877‐1478 or (309) 438‐2160 between 8 a.m. and 4:30 p.m. Monday through Friday. *Presenters: Do not register with this form. Once confirmed as a presenter, you will be automatically registered for the conference through the Connections Conference office. If you have questions, please call 309-438-5185 or send an email to [email protected]. Registration, Lodging, & Professional Development Hour Information Registra on fees include: Ques ons? Confirma on Professional development hours (Formally known as CPDUs) For registra on ques ons call Illinois State University Conference Services at (309) Wednesday, March 25, 2015 ‐ Opening keynote, 438‐2160 or (800) 877‐1478. For ques ons about the sessions, visit sessions with Professional Development Hours, www.connec onsproject.illinoisstate.edu or call Connec ons Conference staff at con nental breakfast, lunch, and the evening (309) 438‐5185. networking social (hors d'oeuvres and DJ) Thursday, March 26, 2015 ‐ Closing keynote session, sessions with Professional Development Refund/cancella on policy If cancella ons are made in wri ng at least 10 days prior to the conference, Hours, con nental breakfast, and lunch registra on fees will be refunded, less a $15 processing fee. However, no refunds will be made for cancella ons received within 10 days of the conference. Registra on deadlines: Early registra ons must be postmarked by Lodging February 16, 2015 to ensure early registra on Lodging is the responsibility of the individual registrant. Since the room block does fees fill up quickly, we encourage you to make your reserva ons early. When calling, be Regular registra on begins February 17, 2015. sure to men on you are a ending the Connec ons Conference. The last day to register by phone, fax or on‐line is For reserva ons: Pheasant Run Resort 800‐474‐3272 March 20, 2015 Return confirma on includes a receipt for fees and a map to Pheasant Run Resort in St. Charles, Illinois. If you have not received confirma on at least 10 days prior to the conference, please call Illinois State University Conference Services at (309) 438‐ 2160 or (800) 877‐1478. Onsite registra on is available only with payment by either credit card, check, or cash for regular registra on prices. 1‐7 Professional Development Hours (PDHs) are available for a ending the Connec ons Conference. One PDH will be awarded for every one‐hour breakout session that you a end. In your conference packet you will find a PDH Proof of A endance form that you will take to each breakout session. At the end of each session, ask the presenter for a PDH Proof of A endance label. You will receive your proof of PDHs by mail a er the conference is completed. (Note: Check your conference bag for PDH guidelines, paperwork, and mail‐in informa on or see the Connec ons registra on desk on‐site prior to the opening comments). NEW DEADLINE to return PDH proof of a endance by: Must be postmarked by April 2, 2015. Tentative Agenda for the Connections Conference 2015 Tuesday ‐ March 24, 2015 7:00 p.m. ‐ 9:00 p.m. Early Presenter & A endee Registra on Wednesday ‐ March 25, 2015 8:00 a.m. ‐ 9:00 a.m. 9:00 a.m. ‐ 10:30 a.m. 10:45 a.m. ‐ 11:45 a.m. Noon ‐ 1:00 p.m. 1:15 p.m. ‐ 4:45 p.m. 5:30 p.m. ‐ 9:00 p.m. Registra on & Con nental Breakfast Opening Keynote Presenta on Breakout Sessions Luncheon in the Megacenter Breakout Sessions Including the 2‐hour “deep dive” sessions 50’s themed Evening Networking Social with hors d'oeuvres and DJ Thursday ‐ March 26, 2015 7:30 a.m. ‐ 8:30 a.m. 8:30 a.m. ‐ Noon 12:15 p.m. ‐ 1:15 p.m. 1:15 p.m. ‐ 2:15 p.m. Registra on & Con nental Breakfast Breakout Sessions Including the 2‐hour “deep dive” sessions Luncheon in the St. Charles Ballroom Closing Keynote Presenta on Illinois State Board of Educa on 100 North First Street Springfield, IL 62777‐0001 www.isbe.net Gery J. Chico Chair Christopher A. Koch, Ed. D. Superintendent An Equal Opportunity/Affirma ve Ac on Employer Printed by the Authority of the State of Illinois November 2014 (17,500 copies grant agreement number: 15‐3220‐PD‐17‐064‐5450‐51) Connec ons Conference 2015 Technical Assistance for Rigorous Academic and Career Technical Educa on Project (Connec ons Project) Illinois State University Campus Box 1600 Normal IL 61790‐1600 Connections Conference 2015 Rigorous Academic Career & Technical Education Registration Form March 25 & 26, 2015 Pheasant Run Resort in St. Charles, Illinois Connections Conference 2015 Technical Assistance for Rigorous Academic and Career Technical Educa on Project Illinois State University Campus Box 1600, Normal, IL 61790‐1600 Phone: 309‐438‐5185 Fax: 309‐438‐3211 www.connec onsproject.illinoisstate.edu
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