Registration Form - Step 1

Prefer to register offline? Click here for the printable version of this form.

Registration form for TBD Tutor/Mentor Leadership & Networking Conference. Registration is completed in three steps:

Step 1 - Registration: Complete and Submit the registration form separately for each person attending the conference.

Step 2 - Payment: Select and Pay for one or more registrations.

Step 3 - Confirmation: Check your email for your email confirmation letter.

If you have any questions during this process, please contact us at tutormentor2@earthlink.net.

Complete and submit the registration form separately for each person attending the conference.

Contact Information

*First Name:
*Last Name:
Title:
Program/Department:
Organization/Company:
Address:
City:
State:
Zip:
Phone:
Fax:
Website:
*Email:

*Your email address will be used to confirm your registration.  You will also be added to a mailing list for important Conference announcements and information. You can unsubscribe from this list at any time.  We will not share, sell, or spam your email address.

Lunch Options

 Please check this box to request a vegetarian lunch.

Online Attendee List

We maintain an online list of people attending our conference. This list is intended to help attendees connect with other attendees. People will be able to contact you via a form but your email address will not be revealed.

Yes, please add me to the online list of attendees for this conference.


This is a one-day conference.

Friday, TBD - full day $50 (reduced rate!); ask about group rates

Friday, TBD - full day scholarship $30

Friday, TBD - afternoon workshops FREE

How will you pay for this registration?

Online via PayPal

By Mail (check) Use address below.

At the Door (cash or check only)

Payment & Mailing Address

Make checks payable and mail to: Tutor/Mentor Connection, Tutor/Mentor Institute, LLC., Merchandise Mart PO Box 3303, Chicago, Il. 60654.


Notice: The Tutor/Mentor Leadership and Networking Conference has not been held since May 2015. However, the T/MC and Tutor/Mentor Institute, LLC are still active on social media and through blogs and web sites. Reach out and stay connected. .

Questions or Comments (If requesting a scholarship, write in the comment box that you agree to the $30 scholarship rate. If registering for FREE Friday afternoon ONLY, say this in comment box.):

When you click Send, your form will be sent immediately.  Please double check your information before you click Send.

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