Last updated: 07/01/09
Home | Midwest Beyond IQ | Program | Young Adults | Registration Payments | Mail
Beyond IQ: Midwest
Family Dynamics
St. Charles, Illinois, July 10-12, 2009
How To Register:
You can register for Beyond IQ in three ways:
- By Credit Card or Check – using PayPal
- By Mail – print out the form below, fill it in, and send us a check (see address at the bottom.)
- At the door – Walk-ins are welcome.
Beyond IQ Registration Form
Please print this form and bring it with you, even if you have mailed a copy in.
To use a credit card, click here.
Basic Information
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Name |
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Street Address |
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Street Address |
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City |
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State/Province |
Zip/Postal Code |
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Country |
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Phone Number |
Fax Number |
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Institution (if any, for badge) |
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Registration Fees
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category |
Pre-Conference (Friday) |
Conference |
One Day Only |
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1st Adult |
$25 |
$50 |
$30 |
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2nd Adult |
$20 |
$40 |
$20 |
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YA/Grad Student |
$15 |
$30 |
$20 |
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1st Child |
N/A |
$30 |
$20 |
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Additional Children (each) |
N/A |
$25 |
$15 |
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Registration type |
Family Parent College or Grad Student Teacher Administrator Counselor/Therapist Presenter Presenter w/Family |
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Number in party: |
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Age(s) of Child(ren): |
For children too young to participate in the children's programming, click here.
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Post-secondary Student at: |
(if applicable) |
If you are registering as a Post-secondary Student, give your institution and be prepared to show a student ID when you pick up your registration material.
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TOTAL FOR CONFERENCE REGISTRATION: |
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Friday Workshops: |
Teacher Administrator Counselor/Therapist Combination |
Payment Information
If you are paying with a credit card, click here.
If you are paying by check, make it payable to:
Gifted Conference Planners
c/o 7 North End Rd.
Townsend, MA 01469-1124
Comments and Notes
Problems? Questions?
- Contact Gifted Conference Planners.
And finally ...
- Print two copies of this form now; bring one with you and keep one for your own records.
Click here to clear the form and start over: <INPUT TYPE="reset">
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