2010 Mail-In Registration
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.
Ordering a shirt?
For sizes  information
CLICK  HERE!
ATTENTION! This registration form is for registering through the mail. Complete the
registration below and then press submit. You will then need to print the sheet and mail it.
-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