USING INNOVATIVE METHODS AND PARTNERSHIPS

TO ENHANCE PROGRAMS THROUGH EVALUATION

 

Step 1:  Please copy this registration form (minus Step 2) into a blank email, fill it out, and send it to seacoordinator@southeastevaluation.com.

 

Registration Form

 

Today's Date:  ________________________________________________________________________________________________

 

Name:  _____________________________________________________________________________________________________

 

Affiliation:  __________________________________________________________________________________________________

 

Address:   ____________________________________________________________________________________________________

 

City, State, Zip:  _______________________________________________________________________________________________

 

Work Phone:   _________________________________________________________________________________________________

 

E-mail address:   _______________________________________________________________________________________________

 

Coffee, lunch, snacks, and parking are free with your registration (February 22-23).  Please confirm your attendance at the lunch:

Will you be eating lunch on Monday, February 22?

_________     Yes ( _____ request vegetarian meal)          __________     No

Will you be eating lunch on Tuesday, February 23?

_________     Yes ( _____ request vegetarian meal)          __________     No

 

Are you attending the Pre-Workshop on Monday, February 22, 8:30 - 11:30 a.m., with Melinda Forthofer, Ph.D.?

 

        ___________     Yes        

 

         __________     No

 

Do you plan to join SEA or renew your membership for 2010*?  If you join now, you will receive membership rates for the pre-workshop (8:30-11:30 on Monday, February 22) and the workshop (11:45-4:30 on Monday, February 22 and 8:30-4:30 on Tuesday, February 23, 2010)

 

  ________  Yes       ______  No     ______   I have already joined SEA for 2010

 

*  SEA membership dues can be paid with a credit card using PayPal via the "membership" link above.  Dues must be paid by February 22, 2010, to receive membership rates for the pre-workshop and workshop.

 

 

Payment Options

 

We offer two payment options:

 

________  I plan on paying with a credit card using PayPal on SEA's website (see Step 2).
 

________  I plan on paying with a check (please make check payable to "Southeast Evaluation Association" and mail to the address below). 

 

 

Please check the appropriate line for the amount you will be paying:  
 

Joining SEA for 2010 and paying the registration fees: 

 

__________   Pre-Workshop only (8:30-11:30, Monday, February 22):  $75 (registration fee) + $30 (dues) = $105

 

__________   Workshop only (11:45-4:30 on February 22; 8:30-4:30 on February 23):  $125 (registration fees) + $30 (dues) = $155

 

__________   Pre-Workshop and Workshop (8:30-4:30, February 22-23):  $175 (registration fees) + $30 (dues) = $205

 

 

Already a member of SEA for 2010 or planning to pay the dues separately:  Registration fees are: 

 

__________   Pre-Workshop only (8:30-11:30, Monday, February 22):  $75 (registration fee)

 

__________   Workshop only (11:45-4:30 on February 22; 8:30-4:30 on February 23):  $125 (registration fees) 

 

__________   Pre-Workshop and Workshop (8:30-4:30, February 22-23):  $175 (registration fees)

 

 

As a non-member of SEA for 2010:
 

__________   Pre-Workshop only (8:30-11:30, Monday, February 22):  $105 (registration fees)

 

__________  Workshop only (11:45-4:30 on February 22; 8:30-4:30 on February 23):  $155 (registration fees)

 

__________  Pre-Workshop and Workshop (8:30-4:30, February 22-23):  $235 (registration fees)

 

 

As a full-time student + annual membership dues:
 

__________   Pre-Workshop only (8:30-11:30, Monday, February 22):  $75 (registration fees) + $10 (student dues) = $85

 

__________   Workshop only (11:45-4:30 on February 22; 8:30-4:30 on February 23):  $35 (registration fees) + $10 (student dues) = $45

 

__________   Pre-Workshop and Workshop (8:30-4:30, February 22-23):   $110 (registration fees) + $10 (dues) = $120

 

 

 

STEP 2:  If you plan on paying your registration fees with a credit card, please select this option and proceed.  If you plan on mailing your check to SEA, please see the address below.  If you need an invoice, please email Bernadette Howard at seacoordinator@southeastevaluation.com.

 

 

 

Cancellations
Registration refunds will be subject to a cancellation fee of $25 after February 5, although the registration may be used by another person at your work place.  For more information about fees or payment arrangements, please call SEA Treasurer Jennifer Johnson at (850) 488-1023 or email Bernadette Howard, SEA Coordinator, at seacoordinator@southeastevaluation.com.

 

 

 

 

Thank you!

 

 

If you have any questions about registration, please contact the SEA Coordinator at seacoordinator@southeastevaluation.com .

 

 

Southeast Evaluation Association
P. O. Box 10125
Tallahassee, FL 32302

SEA's Federal ID number is

59-2854523