1 ST ANNUAL CALIFORNIA STEM SYMPOSIUM INVEST IN CALIFORNIA

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STEM Conference Registration Form - STEM Conference-Science (CA Dept of Education)

1 ST ANNUAL CALIFORNIA STEM SYMPOSIUM INVEST IN CALIFORNIA 1

1 ST ANNUAL CALIFORNIA STEM SYMPOSIUM INVEST IN CALIFORNIA

st Annual California STEM Symposium

Invest in California STEM Education:

Innovate, Integrate, and Inspire!

November 18-19, 2013

Sacramento Convention Center

1400 J Street, Sacramento, CA



REGISTER EARLY – SPACE IS LIMITED!




Reminder: A separate registration form must be submitted for each attendee at the Science, Technology, Engineering, and Mathematics (STEM) Symposium. Registration is based on the date the payment and completed registration form are received.


Registration must be completed prior to the conference. Onsite registration will not be offered.


Conference Registration (Please check the registration amount that applies)



REGULAR Attendee Registration:

$280.00 Registration and payment must be postmarked by October 18, 2013. One registration form must be completed per attendee.

PRIMARY PRESENTER Registration:

$100.00 Reduced Rate for: One (1) primary presenter may pay a reduced registration fee of $100.00. Registration and payment must be postmarked by October 18, 2013.

LATE Registration:

$350.00 After October 18, 2013,

Contact Jordan Wente at [email protected] to confirm space availability for attendance at the conference.


Last name First name MI

Job title

District Name/Organization

School Site

Street Address

City State Zip


Day phone Fax


E-mail address

Please check the following boxes as appropriate:

I will be attending the Monday opening lunch.

I will be attending the Tuesday closing lunch.

I require vegetarian meals.

Please describe any special needs (sign interpreters, braille materials, etc.):

______________________________________________________________________

Registration: Registration form and payment must be postmarked by October 18, 2013. Registration forms postmarked after that date will be accepted only if space is available.

W-9 Forms- Completed W-9 forms can be found online at www.cdefoundation.org/stemconference/ under the forms link.

Refund Policy: Requests for refunds must be made in writing by June 30, 2013. A $25 administrative fee will be applied. No refunds will be approved after June 30, 2013.

Inquiries: For information about conference registration contact Nancy at [email protected]

For payment inquiries, please contact Jordan Wente at [email protected].

Purchase orders (POs) will not be accepted.

Payment by check or credit card only will be accepted and must be mailed to the address below.

Check made payable to Californians Dedicated to Education Foundation. Please place “STEM Conference” in the memo field on the check.

For Credit Card Payments please use our Online Registration at http://californiastemconference.eventbrite.com/



Mail completed form with payment to:

Jordan Wente, Chief Operations Officer

Californians Dedicated to Education Foundation

11501 Dublin Blvd, Suite 200

Dublin, CA 94568


Attention: STEM Conference Registration


Note: The Californians Dedicated to Education (CDE) Foundation reserves the right to delete or substitute sessions or make other changes to the conference program without notice. Audio and video recordings are strictly prohibited without written approval from the CDE Foundation. The CDE Foundation is not responsible for lost or misdirected mail or e-mail. Purchase orders will not be accepted and will be returned. Do not delay your registration; only checks and payment by credit card will be accepted for registration.


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