2015 CONFERENCE REGISTRATION TYPES AND FEES
By 7/21/15 After 7/21/15 Amount Regular $495 $545 _______ Full-time student (must send copy of student ID, institution, & department) $285 $335 _______ Group (per person—minimum of 3 people) $395 $445 _______ University Wisconsin System employee $395 $445 _______ Fundamentals of Online Teaching Conference Certificate (must register by July 9) $850 n/a _______ $225/person or $450/group of 3 _______ $25 $30 _______ $95 $110 _______ $45 $55 _______ $95 $110 _______ $30 $40 _______ TOTAL $ _________ 2015 CONFERENCE REGISTRATION TYPES AND FEES □ □ □ □ □ □ Virtual conference (NOTE: Group must include 3 names/3 email addresses) Optional Tuesday Activities □ Networking Lunch *Free with 2 half-day workshops □ Morning Half-Day Workshops (8:30-11:30 am) __AM-1 __AM-2 __AM-3 __AM-4 __AM-5 __AM-6 __AM-7 __AM-8 __AM-9 (90-minutes; online; 10-11:30 am) □ Afternoon Half-Day Workshops (1:30-4:30 pm) __PM-1 __PM-2 __PM-3 __PM-4 __PM-5 __PM-6 __PM-7 __PM-8 □ Workshop surcharge, if not attending conference Roster □Please omit my contact information from the roster. Special dietary requests □Vegetarian □Other _______________________________ The items below are included in conference fee, but you must pre-register. Orientation to the Conference □Will attend □Will not attend Special Interest Groups (SIGs) Both SIGs will meet Tuesday, August 11 at 1:30 pm. □Military Education □Workplace Training & Development □Will not attend Thursday Lunch & Keynote, 11 am-12:30 pm □Will attend Thursday Conference Finale w/desserts, 2:45-4 pm □Will attend □Will not attend REGISTRANT INFORMATION (please print) Name Job title __________________ Organization Business address City/State/Zip/Country Email ____________________________________________ Phone PAYMENT METHOD □ P.O. or check enclosed (Payable in U.S. funds to UW–Madison) □ MasterCard □ VISA □ American Express Cardholder’s Name Card No. Expires WAYS TO REGISTER • Online (may only pay by credit card) https://dtlconference.wisc.edu • Phone: 608.262.0810 • Fax: 800.741.7416 or 608.265.3163 • Mail: DT&L Conference Pyle Center, Dept. 111 702 Langdon St., Madison, WI 53706 Cancellations & Refunds Call Registration at 608.262.0810 to cancel. If you do not attend and did not cancel prior to the conference, you are responsible for the total fee. If you registered and cannot attend, you may send a substitute. • Cancel by 7/29/15: Full refund less $30 • Cancel by 8/04/15: 50% refund • Cancel after 8/04/15: No refund Please advise us at time of enrollment if you have a disability and require special accommodations. Requests are confidential. If you need this material in an alternate format, contact the conference manager at 608.265.4159 or the UWEX Affirmative Action at 608.262.0277.
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