35th ANNUAL IOWA INDUSTRY & TECHNOLOGY EDUCATION CONFERENCE
2010 IITE Conference Registration Form
October 28-29, 2010	QUALITY INN & SUITES CONFERENCE CENTER, AMES

Thank you for your interest in attending the 2009 IITE Conference. Please submit the online form below and we will send you an invoice; or call

319-273-5141 and we'll send you a Registration form and brochure.

Questions about Registration? Contact University Events Coordination at 319-273-5141 or conf-events@uni.edu

Contact Information Full Name School Street Address City State Zip Phone Fax Email Special needs, including dietary   Registration Information Please indicate the conference events you wish to participate in by placing a check mark in the appropriate boxes. IITEA and IACTE memberships included with registration Registration Fee Thursday Tech Updates* Thurs. Evening Banquet $25 each Friday Luncheon $0 participant, $15 guests Conference Tour $20 each Early Registration By October 16 $105 A W G C Choose a Thursday Tech Update from the list Regular Registration After October 16 $125 Student Registration $25 Retired Members Registration $20 Tech Update Only Registration $50 Guest(s) Registration No memberships included $0   Name(s) of attending guest(s)       * A=Auto; W=Welding; PE=Power & Energy; M=Millwork     INTERESTED IN GRADUATE CREDIT I am interested in receiving one hour of uni credit for $120 (a special tuition rate for teachers, in addition to the conference registration fee). Please send me additional details. note: participants that enroll for credit will be billed after the conference – please do not include tuition payment with conference fee.     25-year, 35-year & Retiree Club If you have worked in technology or industrial education for 25 or 35 years, or have recently retired, you deserve to be honored for all of your hard work and dedication To be recognized in the Thursday evening banquet, complete the form below, register for the conference and reserve meals for yourself and guests. Club Application: 25 year 35 year Retiree Years of Service: 1. School Start Year End Year 2. School Start Year End Year 3. School Start Year End Year Payment Information Submitting payment Please check your preferred method of payment below. We will send you an invoice with your confirmation letter. Check or credit card Note: For security purposes, we will request specific credit card information on your invoice that will be mailed to you. P.O. or Requisition # Comments and Special Needs Please provide us with any information that could help make your conference experience a more enjoyable one.  You may also use this space to list any special needs, including dietary. As the Conference approaches, you will receive an invoice via postal mail with your confimation letter. University Events Coordination requests this information for the sole purpose of submitting your proposal for this program. We do not routinely release any of this information to anyone outside our institution without express permission. We do ask that you fill out all items that apply to you. We are unable to process forms that do not include your name and address. The University of Northern Iowa is an equal opportunity educator and employer with a comprehensive plan for affirmative action.