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39th Annual Early Chilhdood Education Conference August 10-12, 2009 ENGAGE, CHALLENGE, INSPIRE, LEAD www.asuececonferen ce.blogspot.com

INSPIRE, LEAD ◊ www.asuececonferen ce.blogspot.com ASU CHILDHOOD SERVICES 2009 Early Childhood Education

ASU CHILDHOOD SERVICES 2009 Early Childhood Education Conference Registration form Jonesboro, AR August 10-12

Last name

First name

TAPP Registry ID # (or SSN)

Summer Mailing Address

City

State

ZIP

Organization /Workplace

Work Address

E-mail (Important! Your registration confirmation will be e-mailed to you if possible.)

Your Preferred Phone #

Check here if you plan to attend the Curriculum Institute

Annual Conference Registration—Monday through Wednesday (Aug. 10-12)

1. Early Bird Registration

2.

Regular Registration

 

3.

One-Day Registration Only

Fees (If Postmarked by June 15):

Fees (Through July 20):

 

Fees:

 

Registration

$99

Registration

$125

Registration

$55

Box Lunch

$24

Box Lunch

$24

Monday or Tuesday (circle one)

Dinner (Mon. only)

$12

Dinner (Mon. only)

$12

Box Lunch

$8

Undergraduate Credit (1 hr.)

Undergraduate Credit (1 hr.)

4.

Curriculum Institute

Resident

$163

 

Resident

$163

Fees:

 

Non-Resident $427

$427

Registration

$175

Graduate Credit (1 hr.)

Non-Resident Graduate Credit (1 hr.)

 

(includes lunch all 3 days)

Resident $208

 

Resident

$208

Dinner (Mon. only)

$12

Non-Resident $530

Non-Resident

$530

 

Purchase Orders, Money Orders, and Checks Accepted —> —> —> TOTAL Registration fee enclosed

(payable to ASU Childhood Services)

$

*************************************************************************************************************************************************************************************************************************************************************************************

*Undergraduate or Graduate Credit Options are contingent upon prior ASU or ASU Graduate School Admission. **Lodging & breakfast will not be available on campus this year. Childhood Services has negotiated a conference rate with these area hotels:

Comfort Suites, 3404 Access Road, 870.3362280, $93/night , free continental breakfast, indoor pool, free wifi, all rooms suites Holiday Inn Express, 2407 Phillips Drive, 870.932.5554, $85/night, free contine ntal breakfast, fitness center, free wifi, business center

Scholarship Information ASU Childhood Services and DHS Division of Child Care and Early Childhood Education are pleased to announce a limited number of scholarships for the conference. Employees of licensed and registered child care programs are eligible to apply. The purpose of the scholarship is to improve the quality of early childhood programs in the state of Arkansas through staff development opportunities. Scholarships are available for centers and family child care homes.

If awarded, your scholarship will cover the cost of 3 day registration only. The scholarship will not cover the cost of meals, lodging, travel expenses, college credit courses, continuing education units (CEUs), or substitute staff costs.

Scholarships are available on a first come, first served basis, using the following criteria:

 Staff employed for less than a year in a child care facility  Programs on program improvement plans  New child care facilities  Licensed capacity of program

Check here if applying for scholarship Number of years your program has been in operation

Licensed capacity of program

License #

Your position within program

 

Number of years you have been employed in child care

Have you attended this conference before?

Return form to ASU Childhood Services, Attn: ECE Conference PO Box 808 State University, AR 72467

(No faxed forms accepted)