California Reading Association
50th Professional Development Institute
October 20 21, 2017

Individual Registration Form

NOTE: This form is for individual online registration only. Payment via credit card or PayPal is required.
If you wish to mail a payment, you must use the mail-in registration form.

Required fields are in blue

First Name: Last Name:
Home Address:
City: State: Zip:
E-mail Address: Phone:
School District/Affiliation:
Position:

Institute Pass - includes General Sessions, Exhibits and Sessions/Workshops.
Both Days - pass includes Kick-Off Party (Oct. 20) and Lunch (Oct. 21)

I want to join CRA ($40 for 1 year membership) and register for the PDI at the member rate
   
Registration
Fees
Friday OnlySaturday OnlyBoth Days
   
Early Bird
Before 9-20-2016
9-20-2017 to
10-9-2017
Early Bird
Before 9-20-2017
9-20-2017 to
10-9-2017
Early Bird
Before 9-20-2017
9-20-2017 to
10-9-2017
Member     $75 $235
Non-Member     $75 $275
Pre-Service
Teacher/Intern/Full
Time Student
$50
CYRM Dinner · Saturday, Oct. 21, 2017 · 5:00 pm - 7:00 pm ticket(s) @ $60 ea
   
PayPal fee
   
Total to be charged
   

Comments/Special Instructions:

Note: PRE-SERVICE / FULL TIME STUDENTS... May register by US Mail or Online.
If registering as a Pre-Service Teacher or Full Time Student, either by US Mail or Online, you MUST submit to CRA a class enrollment copy of proof.

  • If mailed, attach an enrollment copy of proof, along with your registration form and payment.
  • If registering and paying Online, please mail or fax a copy of proof to CRA. Be sure to include your PayPal receipt # and date your registered online.

AT CHECK OUT you will be asked if you will pay using PayPal or a credit card. Click on the type of payment you will be using and fill in all required payment information. Once payment is complete, a thank you/confirmation page will appear. Print this confirmation and bring to the event. A copy of your registration and payment will be sent to CRA. You will receive a receipt via email.

IF YOU DO NOT COMPLETE REGISTRATION PROPERLY AND PAYMENT PAGES PROPERLY, YOUR REGISTRATION WILL NOT BE PROCESSED. MAKE SURE YOU GET A PAYMENT RECEIPT FROM PAYPAL THAT LISTS A RECEIPT NUMBER.

Note: Please make sure all information above is accurate and complete before submitting your registration. You will not be able to make corrections once the registration is submitted.