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About SSDA

2010 Northern (Redding) California Regional On-Line Registration

by Shelly Tillery

 Location of Regional:

Monday, October 25, 2010

Shasta County Office of Education

1644 Magnolia Avenue

Redding, CA  96001

(530) 225-0285 

(lunch is included with your registration)

 

Attendees  Names: 

(for additional attendees, please use the "comment" section at the bottom of this registration form) 

 

  

District/Company  
Address    City    Zip
Phone    Fax  

E-mail Address

(please use "one" e-mail address where follow-up materials will be sent)
2010 REGIONAL REGISTRATION RATES:
 

 

Member

 

Non-Member
1st Registrant $100.00 $200.00
Subsequent Registrants $65.00 $200.00

 

P.O.# Credit Card   Visa MasterCard AMEX
Billable Amount:$
Credit Card # Exp.
Billing Address:
Name as it appears on card:
Date:  

Comments or additional attendees:

 

 

 
 

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