Registration Form - Tutor/Mentor Conference at TBD., Chicago, Il.

This conference has not been held since May 2015 due to lack of funding.

If Register Online form is not working, print and mail this registration form.

Registration is completed in three steps:

Step 1 - Registration: Print and complete the registration form separately for each person attending the conference.  Mail form (prior to tbd) or Fax to 312-787-7713

Step 2 - Payment: Pay using  this PayPal Form or Send payment by mail. You may also pay at the door.  See mailing address below.

Step 3 - Confirmation: Check your email for your email confirmation letter.  If you do not receive an email within two weeks of your registration, please contact us.

If you have any questions during this process, please use the contact us form or email

Please print, complete and mail/fax one registration form for each person attending the conference.  

Contact Information

First Name*:__________________  Last Name*: _____________________


Program/Department: _________________________________________



City:_____________________  State:________  Zip:________________





*Your email address will be used to confirm your registration.  You will also be added to a mailing list for important November 2014 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

With your permission we will add you to 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.

Fees for Conference:

__ $50 in full day

__ Group of 3 or more, $50 per person (contact us if you'd like lower group rate)

__ Scholarship requested - $30 fee

Contact Tutor/Mentor Institute at to discuss different group rates.

How will you pay for this registration?

__ Online via PayPal

__ By Mail (check)

__ At the Door (cash or check only)

Questions or Comments:
If requesting $30 scholarship write that you accept $30 scholarship rate and include check. This is automatically approved.

You may fax your registration form to 312-787-7712 Attn: Dan Bassill

Mail your completed registration form, along with your payment, to:

Tutor/Mentor Institute, LLC
c/o Merchandise Mart PO Box 3303, Chicago, Il. 60654

Make checks payable to Tutor/Mentor Connection, Tutor/Mentor Institute.

Please Note: Do not mail registration after tbd. With advance written notice (fax or email), we will refund the registration fee, less an administrative cost of $30 per day registered. There will be NO refunds for "no shows" on the day of the Conference and you will be responsible for the full registration fee.

Thank you for your registration.  Registrations received by tbd will be confirmed via fax or email.

NOTE: As of 7/1/2011 Tutor/Mentor Connection has been restructured and is no longer a 501-c-3 non-profit organization. Conference fees will not be tax exempt. The Tutor/Mentor Institute, LLC has been created to support this effort.