Registration Form for November 7, 2014 Conference
Print and complete this form (PDF version) to register to attend the November 7, 2014 Tutor/Mentor Leadership and Networking Conference which will be held at Metcalfe Federal Building, 77 W. Jackson, 3rd Floor, Chicago, Il.
Submit one form for each person that you are registering.
*By providing your email address, you agree to be added to a mailing list for
important Conference announcements and information. You can unsubscribe
from this list at any time.
____ Please check to request a vegetarian lunch.
____ Please check to be added to the online attendee list which enables
other contact participants to contact you via a form on the Conference Web site.
Your email address is not shared through this process.
____ Monday, November 4, Single day conference registration - $80
____ Group Rate, $50 per person for groups of 3 or more (contact Dan Bassill if you need a lower group rate, or a 50% discount half day rate.)
____ Scholarship Rate, $30 per person
Registration Fees (Register the day of the Conference):
Single day registration - $80 (check or cash only)
Scholarships and group discounts are available. Please
for scholarships or group rate information.
How will you pay for this registration?
__ Online via PayPal (click here for PayPal)
__ By Mail (check)
__ At the Door (cash or check only)
Please make checks payable to Tutor/Mentor
and mail payment to Daniel Bassill at
Tutor/Mentor Institute, LLC
Merchandise Mart, PO Box 3303
Chicago, IL 60654
Please Note: 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 one week prior to the Conference will be confirmed via fax or email.
Tutor/Mentor Institute, LLC is not a 501 (c) (3) tax-exempt non-profit.