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ABC's of Literacy Registration

To register, please fill in the contact information below, and click "Submit Request." Confirmation, including maps and directions, will be sent within two weeks of our receipt of completed registration form and payment.

Registrant Information
Name:
Name to Appear on Badge:
Title:
Organization:
Address:
City:
State:
Zip:
Phone:
Fax:
E-Mail:
Dietary Needs*:
*If yes, please specify:
Special Needs:

Areas of Interest (Please check all that apply)
Adult Education	Advocacy
Early Childhood Education	Education and Technology
ESOL	Health Literacy
Libraries and Literacy	Literacy Tutor Training
Parental Involvement	Reading
Social Service	Literacy and Business
Numeracy	Networking
Student Leadership	Social Justice
Other:

Registration Type (Please check which day(s) you will be attending)
Thursday (May 18)	Friday (May 19)
Both days

Method of Payment (Made payable to LIFT)
Check	Money Order
Purchase Order #:
Postmarked by May 5
Thursday only - $25	Friday only - $20
Both days - $40
I accept that I owe a check, money order, or purchase order, made payable to LIFT, and that my registration will not be confirmed until payment is received by LIFT. Payment should be mailed to LIFT, Attn: ABC's of Literacy, 815 Olive Street, Suite 22, St. Louis, MO 63101. To continue, please select "I Agree" in the menu below.

Copyright © 2006 Literacy Investment for Tomorrow