Late Registration (Independent)

Reading and Writing Workshop for grades 6-12. March 21, 2020, Enterprise Middle School, Richland. Please use after February 7th.

Full payment due by event. $30.00 per student.

School Name if Other {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

District Name if Other {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Student Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Student Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Supervising Teacher Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Guardian Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Guardian Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Do we have permission to use any photos taken at the event for promotional materials and website? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Select your top 6 authors, or Panels, for Workshop preferences. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Workshops not guaranteed due to late registration.

Registration Fee {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Send Check to The Literacy Connection or use the link below to pay with PayPal

Method of Payment {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{~ Payment_Block_Label}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{binding Name}:	{binding displayValue}	---

{{ Cognito.resources['payment-amount-due'] + ":" }} {binding displayValue}

Late Registration (Independent)

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}

{{ Cognito.resources['order-date-label'] }}: {binding displayValue}

{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:	({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:	{binding displayValue}

Full payment due by event. $30.00 per student.

School Name if Other {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

District Name if Other {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Student Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Student Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Supervising Teacher Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Guardian Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Guardian Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Do we have permission to use any photos taken at the event for promotional materials and website? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Select your top 6 authors, or Panels, for Workshop preferences. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Workshops not guaranteed due to late registration.

Registration Fee {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Method of Payment {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

The email has been sent.

Your progress has been saved.

Copy your form link:

Email me my link:

{ binding firstError.message }

Late Registration (Independent)

Reading and Writing Workshop for grades 6-12. March 21, 2020, Enterprise Middle School, Richland. Please use after February 7th.

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}

{{ Cognito.resources['order-date-label'] }}: {binding displayValue}

{{ Cognito.resources['order-method-label'] }}: {binding MethodReference}

{binding Group}
{binding Name} - {binding Description}	{binding displayValue}
{{ Cognito.resources['payment-subtotal'] + ":" }}	{binding displayValue}
{{ Cognito.resources['order-total-label'] }}: {binding displayValue}
{{ Cognito.resources['order-amount-paid'] }}:	({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:	{binding displayValue}

Full payment due by event. $30.00 per student.

School Name if Other {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

District Name if Other {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Student Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Student Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Supervising Teacher Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Guardian Name {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Guardian Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Do we have permission to use any photos taken at the event for promotional materials and website? {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Select your top 6 authors, or Panels, for Workshop preferences. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Workshops not guaranteed due to late registration.

Registration Fee {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Method of Payment {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Late Registration (Independent)

Full payment due by event. $30.00 per student.

Workshops not guaranteed due to late registration.

{~ Payment_Block_Label}

Late Registration (Independent)

{{ Cognito.resources['order-transaction-details-header'] }}

Full payment due by event. $30.00 per student.

Workshops not guaranteed due to late registration.

Your progress has been saved.

Late Registration (Independent)

{{ Cognito.resources['order-transaction-details-header'] }}

Full payment due by event. $30.00 per student.

Workshops not guaranteed due to late registration.