Leadership Conference Participant Registration Form

18th Annual Southern Illinois
Educational Leadership Conference
SPONSORS:
SIU Department
of Educational
Administration and Higher
Education
Wednesday, March 25, 2015
Illinois Association of School
Administrators
Student Center, 1255 Lincoln Drive, Carbondale, Illinois
Illinois Association of School
Business Officials
Keynote Speaker: Randy Dunn, President,
Southern Illinois University
Illinois Principals
Association
Association of Rural and
Small Schools
Vision 20/20: Promoting Student-Focused Leadership
AdvancED Illinois
LOCATION:
PROGRAM
SIU Carbondale
Student Center
Workshop Sessions will include:
PARKING:
• Legal Issues
• Community and Institution Partnerships
• Technology and Education
• Student Success
• Local, State and Federal Funding
Free parking and shuttle
service available from the
SIU Arena Lot 56 from 7:30
a.m. to 9 a.m. and back from
1 p.m. to 3 p.m .
CONFERENCE SCHEDULE
8:15 am
8:45 am
12-1:15 pm
1:30-2:30 pm
Registration and Coffee
Keynote and Breakout Sessions
Lunch & Presentations
Forums, Roundtables and Services
Registration Form - Deadline to register: March 11, 2015
15W0902201
First Name: _________________________________________________ Last Name: __________________________________________________
School Name: _________________________________________________________________________________________________________________
Address: _______________________________________________________________________________________________________________________
City: _____________________________ State: ________ ZIP: ___________________ Day Phone: _____________________________________
Email: _________________________________________________ Dietary Restrictions: ___________________________________________
PAYMENT INFORMATION
REGISTRATION FEE
 Professional Fee
 Student Fee
$80
$50
If paying by credit card, please fill in information below.
Credit Card #:
Exp Date:
(Must be a full-time SIU student)

EAHE Students
$25
Payment (choose one):
 Check (Payable to SIUC)
 Credit Card (Visa, Discover, Mastercard)
 Bill School (complete billing address to
Name on Card:
Retiring at the end of the 20142015 school year?
 Yes
WAYS TO REGISTER:
Online:
continuinged.siu.edu
Phone:
618/536-7751
Billing Address:
Email Address:
Fax:
618/453-5680
the right)
Mail to: Continuing Education and Outreach, SIU Carbondale, Mail Code 6705, 1255 Lincoln Drive, Carbondale, IL 62901
March 11, 2015
DEADLINE TO REGISTER:
Please share this conference
information with your staff
and other associates.
CONTINUING EDUCATION AND OUTREACH
Student Center—Mail Code 6705
Southern Illinois University
1255 Lincoln Drive
Carbondale, IL 62901
18th Annual Southern Illinois
Educational Leadership Conference
Wednesday, March 25, 2015
Keynote by:
Randy Dunn, President, Southern Illinois University
“Vision 20/20: Promoting Student-Focused Leadership”
BREAKOUT SESSIONS





Legal Issues
Community and Institution Partnerships
Technology and Education
Student Success
Local, State and Federal Funding
REGISTER TODAY!
ONLINE: continuinged.siu.edu
PHONE: 618/536-7751
FAX:
618/453-5680