AISLE 2021 Conference Registration Form

Save time and register through our online registration form. This form is completely secure. Please fill it out completely and submit the form to AISLE. If you wish to print and mail a registration form, please view and print the .pdf version here (requires Adobe Acrobat software browser plugin).

All fields are required to be filled in so that we may completely process this online form.

Personal Information

















Check Preferred Address

Work

Home

Other Information

IEIN, if you wish to claim Professional Development Hours
(Illinois Educators Identification Number)


Are you an AISLE Member?

Yes

No

Are you presenting?

Yes

No

Are you on the 2021 Conference Steering Committee?

Yes

No

Is this your first AISLE Conference?

Yes

No

Check here if you have a disability and require special services.

I require special services.

Conference Registration Fees

Monday, November 8 and Tuesday, November 9

To qualify for the member rate, you must be a 2021-2022 AISLE “Member of record.” The non-member fees include a one year AISLE Membership and subscription to AISLE News. Please see registration fees.

 

MEMBERSHIP TYPE
FULL CONFERENCE
SINGLE DAY (Check One)
 
EARLY BIRD
register by 9/24/21
REGULAR
register by 10/22/21
ON-SITE
after 10/22/21
EARLY BIRD
register by 9/24/21
REGULAR
register by 10/22/21
ON-SITE
after 10/22/21
  Member
$200
$230
$260
$180
$210
$240
  Retired/Student Member
$160
$160
$260
$140
$140
$140
  Non Member
$275
$305
$335
$255
$285
$315
  Colleague: Para/Admin/Student
$180
$180
$180
$160
$160
$160

 

I am a:

Member
Retired
Non Member
Colleague (paraprofessional, administrator, student)

Registration date:

I'm An Early Bird Registrant (registering before 9/24/21)
I'm Registering at the Regular Rate (registering by 10/22/21)
I'm Registering On-Site (registering after 10/22/21)

I'm registering for:

Full conference
Monday only
Tuesday only

"A" Registration Total:


Meals

Click here for complete menu details. (MUST BE PRE-REGISTERED)


Check if you have special dietary requirements. A committee member will contact you for details.

I have special dietary requirements.

 

Monday, November 8

Annual Membership Meeting Luncheon (included in registration fee)
   Select one:
       Turkey with Cheddar
       Chicken Caesar Salad
       Black Forest Ham with Swiss
       Vegan Wrap

 

Award Banquet - $45.00
   Select one:
       Parmesan and panko Crusted Chicken
       Char-crusted flat iron steak
       Roasted vegetable ravioli

 

 

Tuesday, November 9

Readers’ Choice Award Breakfast with Jordan Sonnenblick - $25

Lunch with Eric Kallenborn - Pranzo Buffet (included in registration fee)

"B" Meals Total:


Linking for Learning

Linking for Learning is available for purchase at a discounted rate. You may preorder your book and pick it up at the registration table.

Number of copies:

@ $30.00

"C" Linking for Learning Total:


Registration Total

Total of "A" + "B" + "C" =



Payment Options

Credit Card, Check or Purchase Order

Mail or scan a copy of Purchase Order and send to AISLE Conference Registration, PO Box 110 | Seneca, IL 61360 or email to execsecretory@aisled.org or fax to 309-387-6275.

Complete the following information below.

Payment Options:

Credit Card (online payment)

Personal Check

Purchase Order

 

Please fill out the fields below for online payment using credit card. (We accept VISA and MasterCard)




 

If you would like to use a Purchase Order, please fill out the fields below.










If you want to leave us a message, please write below.



 

REGISTRATION QUESTIONS?
Caroline Campbell, Registrar
Phone: 309-387-6275
Email: registrar@AISLED.org

OTHER QUESTIONS:
Carolyn Kinsella, Executive Secretary
Phone: 815-357-6023
Email: execsecretary@AISLED.org

SPECIAL INSTRUCTIONS:

  • Use a separate form for each person registering (photocopy for your records).
  • Registration form must be postmarked by September 24, 2021 (Early Bird) or October 22, 2021(Regular).
  • Online Registration is available through the AISLE website (http://www.AISLE.org) or IATE website (http://iateonline.org). Online registrations must be received by midnight of the Early Bird and Regular dates listed.
  • Requests for refunds must be received in writing by October 25, 2021.
  • Cancellations will result in a $25 handling fee.
  • Refunds will be made after the conference.
  • Confirmation will be sent for registration received by October 22, 2021
  • Hotel reservation must be made directly with the hotel by October 7, 2021.
  • Please remind your district personnel to process this form in time to meet registration deadlines.
Date Modified: 8/4/21