National Educators Law Institute

Registration Form


*If registering multiple individuals, please complete this form for each attendee.
Conference	:
Total No of Persons	:
Total Amount ($)	:
Name	:
Position	:
District/Co-op	:
Region	:
Mailing Address	:
City	:
State	:
Zip	:
Is Billing address same as Mailing?	:

Billing Address	:
City	:
State	:
Zip	:
Bill to Attn	:
Phone	:
Fax	:
Email	:

Method of Payment	:	Check Purchase Order
Number (if available*)	:	*If sending purchase order separately, fax to (512) 322-9342 or include with payment. Registrants not paying prior to conference will receive mailed invoice after event.