Last name:
First name:
Address:
State:
Zip code:
City:
Work Phone:
Home Phone:
School:
 Subject taught:
Email:
1. 2010/2011 Registration and Membership dues:
$110.00
2. 2010/2011 Student Registration and Membership dues only:
$30.00
3. 2010/2011 Retired Teacher Registration, Complimentary Lunch
and Membership dues only:
$30.00
4. On-Site/Late Registration (postmarked after September 25th)
$125.00
5. Membership Only - not attending conference
$30.00
6. Retired or Student Membership - not attending conference
$20.00
7. IAEA T-Shirt - logo example below
$15.00
8. Total due:
Questions, comments, or feedback:
ATTENTION PLEASE!
After you click "send registration" below you will need to print off the confirmation
page and mail it to

Estuardo Hiram Miranda  
6200 S Peppertree Ave.
Boise, Idaho 83716

Please make checks payable to: Idaho Art Ed. Assoc.
-Please note: Fees for university credit will be paid separately at the conference registration desk. Please
see web site for more information. www.idahoarted.org

**Conference cost includes:  IAEA Membership, Conference materials, Workshop materials and
handouts, Keynote Speaker, Thursday evening Reception, Silent Auction, Friday IAEA Business/Awards.

PRE-REGISTRATION MUST BE POSTMARKED BY SEPTEMBER 25, 2010

SORRY – NO PURCHASE ORDERS
$25.00 PROCESSING FEE FOR CANCELLATIONS – CANCELLATIONS MUST BE
RECEIVED BY SEPTEMBER 30, 2010