IOL Registration Form

First Name:
Last Name:
Title:
Department:
University:
Specify Other:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Email Address:
Daytime Phone:
Name For Tag:

Indicate if someone else is completing this form, or if there is a secondary contact we should use.

Secondary Contact Name:
Secondary Contact Phone:
Secondary Contact Email:

Check here if you do not want your name and contact information on the Participant List that will be shared with conference attendees and sponsors.

Emergency Contact Information

By providing contact information for someone you trust, we can contact them if you encounter an emergency while at IOL. (Optional.)

Emergency Contact Name: Emergency Contact Phone:

Refunds and Cancellations

Cancellations must be received prior to Friday, May 7, 2010 in order to receive a refund less a $50.00 processing fee. Cancellations after May 7, 2010 will not be refunded; however, a substitute may attend for the registered attendee. After online registration closes, the fee to register onsite is $450.

Conference

Early: $350.00 on or before Friday, April 9, 2010
Regular: $400.00 after Friday, April 9, 2010
Grad Early: $275.00 Grad Student Rate on or before Friday, April 9, 2010
Grad Regular: $300.00 Grad Student Rate after Friday, April 9, 2010

All presenters are assessed the same Early and Regular registration fees stated above.

Pre-Conference

Details about preconference workshops can be found on the information page. Some sessions have restricted enrollment or require a wireless laptop. See the website for requirements prior to registration.

None
Developing and Sustaining Second Life Projects: $25.00 Fee (Note session requirements)
Emotional and Multiple Intelligences in the Virtual Classroom: $25.00 Fee (Note session requirements)
SoftChalk Lesson Builder Meets Quality Matters Standards for Online Courses: $25.00 Fee (Note session requirements)

Pre-Conference + Conference Total: $0.00

Meals and Special Needs

Registration fees include a reception on Wednesday, lunch on Thursday and Friday, and a dinner on Thursday. Guest tickets may be purchased separately.
Regular Meal (seafood will not be served)
Vegan Meal
Vegetarian Meal

Do you have any special needs we should be aware of?

Credit Card Payment

To pay using MasterCard or Visa, please fill out the following document and fax or mail it using the payment instructions.

I will pay using a credit card.

Invoicing Using a Purchase Order or Company Check

Purchase Order Number:
Contact Name for Purchase Order:
Phone Number for Contact:
Address 1 for Invoice:
Address 2 for Invoice:
City:
State: Zip:

Please provide a total for all fees:

Would prefer invoice emailed to:
Would prefer invoice faxed to:

Upon submission of this form, you should be taken to a confirmation page. If that does not happen, please contact Margaret Miller at 512-499-4207.

Click Submit to register and receive payment information.