Registration Form

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U.P. Middle School Association’s Conference
Registration Form

Name: __________________________________________

School: _________________________________________

Grade Level: _____________________________________

Address: ________________________________________

City: ____________________ State: ____ Zip: _________

e-mail: __________________________________________

Note: The M-A RESA Conference also will be held at Bothwell Middle School. Conference participants may attend any sessions regardless of which conference they registered for.

Educator (includes lunch) $25.00 $ _________
Presenter - Free _________
NMU Full-time Student free _________

Total due $ _________

Make checks payable to Northern Michigan University.
Registration must be received by October 1, 2002.

Mail registration to:

Cashier’s Office, NMU
1401 Presque Isle Ave.
Marquette, MI 49855

Account No.: 3-32039-0531