IETA 2018 - Attendee Registration IETA is “Building the Future” in 2018. IETA, in partnership with OETC, is proud to present the largest educational technology conference for the State of Idaho. Come join us to make a difference in education. Learn more membership in IETA. Attendee InformationName* First Last Email* Primary Job Role*EducatorIT DirectorSuperintendentPrincipalEducator Support RoleOtherJob Title*We will print this on your conference name badgeCompany / District InformationOrganization or District Name*District NumberContact Phone*Mailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code IETA MembershipFor more information on membership visit idahoedtech.org/membership.htmlIETA Membership*Your membership helps support IETA efforts such as, Region Meetings, Message Boards, Legislative updates, and expense reimbursements for the volunteer board. We very much appreciate your support.1 year membership–$75No Membership–$0IETA Conference RegistrationFebruary 5-7, 2018 The IETA regular conference runs Tuesday and Wednesday. Monday is not a regular conference day. Monday is reserved for in-depth extended length workshops and special summits like the Blended Summit.IETA Conference AttendanceConference Attendance* No Attendance - IETA Membership Only Monday Tuesday Wednesday Conference Meals*Check all that apply. Monday (Box Lunch) Tuesday (Plated Lunch). Wednesday (Box Lunch) Monday Only: Pre-Conference Interest AreaBlended SummitGeneral WorkshopsIf you are attending the pre-conference workshops on Monday, please select your interest area.Continuing Education Credit*YesNoI am interested in receiving continuing education as part of my conference attendance.Dietary RestrictionsDietary Needs*No RestrictionsVegetarianGluten FreeVegetarian and Gluten FreeCheckoutTotal $0.00 Billing Contact Same as Attendee Contact Billing Name* First Last Cancellation Policy Attendees may cancel by January 27, 2018. for a full refund. Cancellations on or after January 27, 2018 cannot be refunded.Billing Contact Email* Payment Method*Credit CardPurchase OrderPayment Method–Credit CardCredit Card* DiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20172018201920202021202220232024202520262027202820292030203120322033203420352036 Expiration Date Security Code Cardholder Name Payment Method–Purchase OrderPurchase Order #*Billing Phone Number*Billing Address Same as District Address Billing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code