13 Annual Values and Leadership Conference
"Exploring the Intersections of Moral Literacy and Educational Leadership"

CONFERENCE REGISTRATION FORM

Complete the form online. Then print the form and mail (along with a check for $250 US) to:

The 13th Annual Values and Leadership Conference
Attn:  Angela Tzilkowski
Pennsylvania School Study Council
200 Rackley Building
Penn State University
University Park, PA 16802, U.S.A.

You may fax your registration to 814-865-0070. The conference fee may be paid at time of registration or mailed under separate cover. Please make your check payable to "PSSC" (Pennsylvania School Study Council).

***THIS IS NOT AN ONLINE REGISTRATION SYSTEM! Please mail or fax the registration form. ***

Please register me for the 13th Annual Values and Leadership Conference.  I have enclosed a check or money order for $250.00 US Funds only, to cover my share of conference costs.

Make checks payable to Pennsylvania School Study Council, please.
Name

Street Address 

 


City
State /Province
Country
Zip Code / Postal Code
Bus. Telephone
Home Telephone
Email
Affiliation

Faculty Student Other

University/Institution

______________________________________________________________________________
 Mail this form along with the $250.00 US conference registration fee to:

The 13th Annual Values and Leadership Conference
Attn:  Angela Tzilkowski
Pennsylvania School Study Council
200 Rackley Building
Penn State University
University Park, PA 16802, U.S.A.

For further information, please contact Ms. Angela Tzilkowski acr131@psu.edu.

This form is for conference registration only! To register at the Laurel Point Inn, call:
1-800-663-7667 or visit www.laurelpoint.com
There are special conference rates at this hotel (Please mention you are part of the "Penn State University Conference Group".)

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