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Employer
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CO
CT
DE
FL
GA
HI
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ID
IL
IN
KS
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LA
MA
MD
ME
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OR
PA
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UT
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Zip
Employer Telephone
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Special MTSS team rate! A school psychologist, paying early or late registration, may bring up to 3 non school psychologist members of his/her MTSS team at the reduced rate of $50 per team member for one day and $70 per member for two days. :
I am (or by October 1st 2010 will be) a dues-paying member of KASP:
I am a member of KASP who will be attending both days: Amount Due Early $125.00 : Late $155.00
I am a KASP member who be attending Thursday only: Amount Due Early $97.00 : Late $125.00.
I am a KASP member who be attending Friday only: Amount Due Early $97.00 : Late $125.00.
I am not a member of KASP. I will be attending both days: Amount Due Early $155.00 : Late $185.00
I am not a KASP member. I will be attending Thursday only: Amount Due Early $127.00 : Late $155.00.
I am not a KASP member. I will be attending Friday only: Amount Due Early $127.00 : Late $155.00.
I am a student. (Full time-verified: have an advisor email jpersing@emporia.edu from their official school email): Amount Due Early $45.00 : Late $65.00.
I am not a school psychologist, and am an MTSS team member who be attending Thursday only with the following school psychologist:
Amount Due Early $50.00 : Late $50.00.
>
I am not a school psychologist, and am an MTSS team member who be attending Friday only with the following school psychologist:
Amount Due Early $50.00 : Late $50.00.
I am not a school psychologist, and am an MTSS team member who be attending both Thursday and Friday with the following school psychologist:
Amount Due Early $70.00 : Late $70.00.
If you have
problems with this form, please wait a
few minutes and try again. If it works
properly, it will give you a confirmation
receipt.
If still giving you
trouble, please inform the webmaster at jpersing@emporia.edu of your
troubles so I can fix it. Then check back in a few days, or just download the traditional paper form available at the link on the left, and mail it in.