Readers’ Choice Registration

Personal Information

First Name

Last Name

Email Address

Phone Number

Fax Number

School/Organization

Grades Served

Address

Address

City

State

Zip

Registration Options

My school/public library would like to register for: (Check all that apply.)

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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.

Total Price: $0

 

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

Credit Card (online payment)

Card Number

Exp. Month Exp. Month 1 2 3 4 5 6 7 8 9 10 11 12

Exp. Year Exp. Year 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032

CVV Number

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

Purchase Order

PO Number

PO Date

School District Name

District Business Office Address

Name for Accounts payable

Email for Accounts payable

City

State

Zip

Personal Check

If you are mailing a personal check payable to AISLE, please send it to:

Carolyn Kinsella,
Executive Secretary,
P.O. Box 110, Seneca, IL 60360.

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