Louisiana Council for the Social Studies OFFICE USE ONLY:
October 21 & 22, 2010 ● Shreveport, LA Amount Pd. ________
Check No. ________
www.lcss1812.org Receipt No. ________
Badge ________
“Advancing the Standards in Shreveport”
CONFERENCE REGISTRATION FORM
___________________________________________________________ ______________________________________________________
Last Name First Name School or Affiliation
___________________________________________________________ ______________________________________________________
Home Address (Street) School Address (Street)
___________________________________________________________ ______________________________________________________
City State Zip City State Zip
___________________________ ______________________________ ______________________________________________________
Home Phone (Area Code) Cell Phone School Phone (Area Code)
___________________________________________________________ ______________________________________________________
E-Mail Address Grades/Subjects Teaching
CONFERENCE PRE-REGISTRATION FEES: DEADLINE 10-7-10 ON SITE REGISTRATION FEES:
[LCSS membership dues included in fee] [LCSS membership dues included in fee]
_____ Teachers/Administrators $55.00 _____Teachers/Administrators $70.00
_____ Presenter/Pre-service/Retired $25.00 _____ Presenter/Pre-service/Retired $30.00
_____ Municipal Auditorium Ghost Tour (Fri.) $5.00
_____ Awards Cocktail Social at SciPort FREE
_____ Walking Museum Tour (Fri.) FREE
_____ Post-social IMAX Movie at SciPort $8.00
TOTAL PAYMENT ______
**MAKE CHECKS PAYABLE TO: LOUISIANA COUNCIL FOR THE SOCIAL STUDIES (LCSS)**
PLEASE CHECK YOUR STATUS:
____ Elementary School ____ Administrator ____ College/University___________________________
____ Middle School ____ Supervisor ____ Exhibitor__________________________________
____ High School ____ Retired ____ Other ____________________________________
Note: CLUs and Southern Association, Professional Plan and Leadership Academy points may be
earned at the conference. Exhibits will be open October 21 & 22, 2010, with hourly door prizes given.
MAIL REGISTRATION FORM & FEES TO: OFFICIAL CONFERENCE HOTEL:
Susan E. Keith, LCSS President-Elect Holiday Inn Downtown
Caddo Magnet High School 102 Lake Street (I-20 at Spring St. Exit)
1601 Viking Drive Shreveport, LA 71101
Shreveport, LA 71101 PH: 318-222-7717
PH: 318-221-2501/ 318-227-1393 FAX
*Deadline for receiving LCSS group rate ($79.99/night) is September 30, 2010. Please register early!!!