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Minnesota School Psychologists Association Annual Midwinter Conference January 27 & 28, 2011 Registration Name: _________________________________________ E-Mail: _______________________________________ Address: _______________________________________ Employer: _____________________________________ City, State, Zip: __________________________________ Position: ______________________________________ Work Phone: ____________________________________ Current MSPA Member? (please circle) YES NO The MSPA Board decided to keep the fees the same as last year to be sensitive to the difficult economic times. Non-members registering for BOTH days of the conference at the Non-member rate below will be provided with a FREE one-year membership to the organization. Registration Fees Thurs. Fri. Both MSPA member $135 $135 $205 Non-member $165 $165 $275 Student member/Retiree $40 $40 $65 I will attend: (please circle below) Thursday Only Friday Only Full Conference (BOTH days) Lunch will be a sit down meal, not buffet. Please indicate if you: _____ Would like a vegetarian plate _____ Have food allergies: _________________________________ Please submit completed registration form with your check (payable to MSPA) to: Chip Panahon - Membership Psychology Department 23 Armstrong Hall MN State University – Mankato Mankato, MN 56001 If you use a purchase order for registering, cash must be rendered at the conference. • An additional fee of $20.00 will be charged for on-site registration. • Refunds requested after January 21, 2011 are subject to a $25.00 administrative fee.
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