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                                                                    March 6, 7 and 8, 2009
                         (Day part icipants or overnight participants staying off grounds - see other side)
                                        No On-Site Overnight Registrati on - Adults Only
                               *OVERNIGHT REGISTRATION DEADLINE JANUARY 5, 2009
Print your name as you would like it to appear on your name badge.                                 Today’s date ___ _/____/________
Last                                       First                                               Ho me
Name ____________________________ Name _________________________F ___ M ____Phone (_____)___________________
Address ________________________________________ City _______________________________________ State ____ ________

Zip ___________ County _______________________ School _________________________ District ________________________

Email _______________________________________ First Time attendee? _____                                       Work Phone (_______)__________________

                                      *Room Rate Includes 2 Nights Lodging and 6 Meals Per Person
   Rooms are assigned first come first served. Group lodging assignments will not be guaranteed until full payment and registration form is
   received from each participant. For earliest and best selection, include all registrations and fees due in one envelope.
   *Overnight Registration DEADLINE is January 5, 2009. Room assignments must be submitted to Asilomar Conference Grounds by this date.

                                                 Plan A                                 Plan B                                 Plan C
                 Room Type                       Single                              2 to a room                      *3 per room/*4 per room

                                                 $336                              $224 (each)             Director’s Cottage $992 sleeps 6 - Sorry,
                  #1 Historic                Single Room                           2 to a room             no longeravailable -has been reserved.

                                                 $417                              $253 (each)                  $195 each/3 or 4 per room
                  #2 Standard                Single Room                           2 to a room                  *Limited availability/call first

    Room Rate includes all meals. List your CONFIRMED roommates and any special needs ______________________________ Handicapped _____

    1) ______________________________________ 2) ________________________________________ 3) ______________________________________

    All overnight guests (participants,                    Please Select Meal Type                                                 Registration Fee $      125
    friends, spouses…) are responsible                         Regular Meal(s)         ______
    for the registration fee of $125 and                                                                            *Early Bird or Group Discount $ - ____
    lodging fees whether they plan to                          Vegetarian Meal(s) ______
    participate in the conference or not .                                                                                             Lodging Fee $        ____
                                                               Bo x Lunch Saturday ______
                                                COMPLETE PAYMENT MUST ACCOMPANY T HIS FORM                                              Total Due $
 If you are using a Purchase Order, mail or fax the form with the P.O.# to the Registrar. Fax # and address are listed below. On the P.O. include
 participant’s name(s) and a contact person at your school or district office. Call Registrar if you do not receive a confirmation (receipt) of PAID
 registration within 2 weeks of mailing payment. *Early Bird discount is for Registration forms postmarked or faxed in by December 15, 2008.
 Group discount is for 5 or more attendees. Complete one form for each attendee and send in together with payment. Discount for Early Bird or
 Group is $15 per person off the Registration fee. One discount per person.

       Mail this completed form with fees to:             Other Important Information: Registrar Telephone (831) 637-8766 Fax (831) 637-1890
       ARRC Registrar                                     Email ARRCRegistrar@hotmail.com Website www.asilomarreadingconf.org
       PO Box 1157                                        O vernight Registration Deadline is January 5, 2009 or earlier if the number of participants exceeds
       Tres Pinos, CA 95075-1157                          capacity. O vernight Refund Requests and Changes will be accepted only if received by January 5, 2009.
                                                          Registrar will confirm each PAID registration by mail with a receipt of payment. Call Registrar or check with
                                                          your district or school if you don’t receive a confirmation of PAID registration.
         HELP NEEDED!
       Facilitators are needed to
       introduce session speakers.
                                                            Office use    Registration # ________________ Enter Date _____________________
       Yes I’d like to help _______
       No, not at this time _______                         Self-Pay ________ or Paid By ___________________________________________

                                                            PERSONAL CK # ________________ DISTRICT CK # ______________________
       If YES,  time preference
       Saturday _____ AM
       Saturday _____ PM                                    Amt rec’d PERSONAL CK $ ________ Amt rec’d DISTRICT CK $____________
       Sunday _____ AM
       Grade Level Preference_____                          Date check rec’d _____________ Building and Room #________________________
       Thank you!!
                                                            Notes ___________________________________________________                           mail list

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