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Registration Deadline: November 10, 2012

Asilomar Reading Conference Jan. 18-20, 2013
“Literacy Bridges”
Registration Form
Day Only Registration

Deadline for registration:   November 10 -- Mail early to ensure your registration.   

Instructions:  Complete all information; incomplete forms will delay registration.  One form per participant.  Assignments are made only when registration and full payment are received from the participant.  Adults only, please.    Registration will be accepted on a space available basis.  Sorry, no refunds; however, registration may be transferred.  Please notify registrar of any changes immediately.  Late fee ($10) after November 10.

Please Note: All submissions are on an UNSECURE network.  Submit credit card information at your own risk.  If you would prefer to mail your registration, see below.

Type the requested information in each box.  Print your name as you wish it to appear on your name badge. 

If you would like to mail your registration, please download and print a copy of the registration form.  Please Note: If you will be paying by check or P.O., you must download the printable registration form and mail it with your payment.  This will help prevent registration errors.

Click Here to Download Printable Day Use Registration Form

Contact information:
Registration Choices:

Days Attending

Registration Status and Fees

Current SCCRC Member -- $85.00
Renewal SCCRC Member -- $125.00
New SCCRC Member -- $125.00
Non-Member/Guest -- $125,00

Meal Order

Meals and Fees

Friday Dinner -- $28.00
Saturday Breakfast -- $15.00
Saturday Lunch -- $18.00
Saturday Dinner -- $28.00
Sunday Breakfast -- $15.00
Sunday Dining Room Lunch -- $18.00
Sunday Box Lunch -- $18.00

 * required
 * required

Add Required Asilomar Day Use Fee -- $30 -- Not Optional

I acknowledge that a $10 late fee will be added to all orders received after November 10th, 2012
 * required

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