Registration Form

Name:

Address:

City: State: Zip:

Home Phone:

School:

School Address:

City: State: Zip:

School Phone:

E-mail:

Gender: Male Female

Roommate name:

So we can plan our curriculum for you, please indicate your primary interests.

Advising: select one: Beginning Advising: Newspaper Beginning Advising: Yearbook Advanced Advising: Newspaper Advanced Advising: Yearbook

Technology: select one: What's a computer? Help! Just starting InDesign InDesign User, I need tips. InDesign Vet, I want design help Photoshop help Digital Photography help

Help us plan for a productive week for you. Please list items you would desire to be covered in your sessions. This will be forwarded to the instructors.

I would like these items discussed in my advising session:

I would like these items discussed in my technology session:

Workshop Fee: Please note: if you are choosing to stay at a local motel/hotel, select the Off-Campus workshop fee. Contact the motel/hotel directly for room reservations. select one: On-campus $675 Off-campus $375

T-shirt size (included in workshop fee): select one: small medium large X-large 2X-large

Single Dorm Room (if desired): No Yes ($50 additional)

The following items are optional:
Lodging and Meals in dorm for spouse/friend ($300) Yes No

Meal plan for those staying off campus ($100) Yes No

Total due (please add all items with a that you have selected and place total in box):

Your spot in the workshop will be reserved when we receive a minimum deposit of $125.

If you need us to bill your school, please enter the address below along with any pertinent contact or purchase order information. Otherwise we will bill you at the address you listed above. We will send an invoice as soon as we receive your registration:

The workshop may be unable to provide for those with special health needs or disabilities. Please contact us before registering if you may need assistance in these areas.

Additional information you wish to add. Please use this area to list special requests :

Separate payment to OSU needed for OSU credits which is paid Sunday evening. OSU accepts checks, credit cards, PO's, or cash. Do not send any payment for credits at this time.

Remember: registration is not complete until you have sent full payment or a $125 nonrefundable deposit by June 15 to
OJEA Summer Adviser Worskhops
c/o J.D. McIntire
13115 SW Park Way
Portland, OR 97225.

Make checks payable to OJEA Summer Adviser Workshops (no credit cards accepted, PO's are acceptable).