Exit this survey AAUW District 7 Conference Registration 1. Contact information Question Title * 1. Please enter your name as you would like it to appear on your name tag in box 1 and any title and affiliation in box 2 Name Title Affiliation Question Title * 2. Email Question Title * 3. Phone Question Title * 4. Affiliation Question Title * 5. Please select all categories in which you interact with girls and women. childcare worker child development worker early childhood professionals 4-year college 2-year college professor teacher social services athletics advocate parent counselor student support services Other (please specify) Question Title * 6. Please list your preferred breakout session with most desired listed first. You may choose from college-age, high school age, middle school/junior high, elementary, 8 and under. Breakout sessions will be capped at 25 participants. Breakout Session Choice 1 college-age high school age middle school/junior high elementary 8 and under Choice 1 Breakout Session menu Choice 2 college-age high school age middle school/junior high elementary 8 and under Choice 2 Breakout Session menu Choice 3 college-age high school age middle school/junior high elementary 8 and under Choice 3 Breakout Session menu Choice 4 college-age high school age middle school/junior high elementary 8 and under Choice 4 Breakout Session menu Choice 5 college-age high school age middle school/junior high elementary 8 and under Choice 5 Breakout Session menu Question Title * 7. Lunch will be provided as part of the registration fee. Please choose the type of sandwich you would like. Turkey Ham Roast Beef Garden Vegetable Question Title * 8. Registration must be paid for in advance. Early registration closes Sept 17th at midnight. Regular registration closes September 24th at midnight. Those wishing to register after September 24th should call (315)268-6410 and inquire as to availability.Checks should be made payable to Clarkson University with District 7 Conference and participants name in the memo line and sent to: Box 5750 Value U./Media Literacy ConferenceClarkson UniversityPotsdam, NY 13676 Regular Registration $20.00 Late Registration $25.00 Next