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EVENT PRE-REGISTRATION
Please pre-register for the following activities which you plan to attend:

	Sunday evening Dinner & Awards Speakers (no additional fee for paid conference participants - guest tickets available - order below)
	Monday afternoon Scavenger Hunt (no fee)
	Monday evening Cracker Barrel Session & Poolside Party (included - paid conference participants only)
	Tuesday evening Dinner (no additional fee for paid conference participants - guest tickets available - order below)
	Wednesday Closing Lunch & Keynote Speakers (included - paid conference participants only)

  FEES Conference Registration Fee (please check one)

On or before April 21	April 22 - May 22	On-Site
$305	$370	$425

Special Event: Tuesday afternoon Dolphin Tour Not included in registration fee: Limited Seats Available Adults $23.00
Number of Adult Tickets
Children's (10 and under) Please call for availability - $12 each
Number of Children Tickets
Extra Tickets:
	Guest Ticket for Sunday Opening Dinner & Award Speakers (adults only) - $35 Number of Sunday Guest Tickets
	Guest Ticket for Tuesday Dinner - $40  Number of Tuesday Dinner Guest Tickets
	Children's (under 12) Tickets for Tuesday Dinner - $20 each Number of Children's Tuesday Dinner Tickets

Total (Registration fee plus Extra Guest Tickets & Dolphin Tour if applicable) -
$

FORM OF PAYMENT :

	Purchase Order If Purchase Order, please supply PO#  Fax Purchase Order to: (678)839-0636, attn: Dawn Senfeld. Must be received within 24 hours of registration.
	Credit Card (please contact Dawn Senfeld at (678)839-5489 to process card.)
	I will mail a check (drawn on US funds) by May 1, 2010. Please make payable to:  University of West Georgia. Mailto: DLA2010 Conference Attn: Dawn Senfeld University of West Georgia, Distance & Distributed Education /Honors House 1601 Maple Street Carrollton, Georgia 30118.

IF YOU'D RATHER FAX THE FORM:
If you prefer, you may fill out the form, print it, and fax it to us at (678) 839-0636, attention Dawn Senfeld. If you choose to fax the form, do not hit the submit button. You should receive an email confirmation within 1 business day, and a confirmation by mail in 1-2 weeks.

CANCELLATION AND REFUND POLICY:
Checks, purchase orders, or credit card information received at the above address by May 1, 2011 qualify for the lowest rate. Refunds minus $25 cancellation fee will be issued after the conference for cancellations received in writing by May 1, 2011. No refunds will be issued after that date.

INFORMATION FOR INTERNATIONAL REGISTRATIONS:
All registration fees for international (outside of the United States) participants must be received by May 1, 2011. Participants requiring letters of invitation for visa applications for entry into the United States must request these letters by April 1, 2011. To obtain a letter of invitation, please contact Dawn Senfeld at dsenfeld@westga.edu.