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WVAGT Conference Registration Form
Name: _________________________ E-mail: _________________________
Address: ____________________________________________________________________
City, State: ________________________ Zip Code: _________________________
County in which you work: ____________________________________________________
My primary interest in attending this conference is as a: ____ parent, ____ teacher of the gifted, ____ classroom
teacher, ____ administrator, ____ exhibitor/vendor, ____ other
WVAGT Membership? ( ) New ( ) Renewal
Conference Registration Fees
* * * Special Deal! Register early, before October 5th, 2009 and save!!
Fall Conference & Membership for 1 year Early Bird Special----- $100 (includes meals)
Fall Conference & Membership received after October 5th-------- $110
Friday Guest Lunch -------------------------------------------------------- $17.50
Friday Guest Dinner ------------------------------------------------------- $28.50
Membership Only ------------------------------------------------------------ $20
Dinner Options: (Please indicate the number of each if you are bringing a guest)
___ Roasted Pork Loin with Baked Apple Chutney
___ Grilled Salmon Filet in Dill Chardonnay Sauce
Fees may be paid by check, payable to WVAGT (no purchase orders please)
Mail to: Melinda Edwards, Treasurer
1260 Kings Road
Morgantown, WV 26508
Registration Deadline Information
Registrations to include meals MUST BE RECEIVED by October 9, 2009. Meals cannot be guaranteed for late or
on-site registrations.
Please contact Megan Sheeley at shirlisure13@hotmail.com or (304) 668-9833 if you need additional information.