Heartland Christian Educators' Convention

School *

Website

# of students *

Schools with 50 students or less; registratation is FREE. School with 51 or more students, choose the least expensive option in the next field.

Fee calculation instructions:

If your school is a member of Heartland Christian Schools - you pay no convention registration fee - choose "Heartland Member" choice and continue to the next section. (We will be billing you later for your annual dues!)

If your school is NOT a Heartland member AND your enrollment is more than 50 students, calculate your fee as $80 per attendee OR $3 per student, whichever gives you the lowest total.

Select a Choice *

Non Heartland Members: Choose the option that yields the lowest cost.

# students enrolled

Include Kindergarteners but not Pre-K's.

x $3 = fee $ Dollars . Cents

Multiply Number of students x $3

# Teachers Attending

x $80 = fee $ Dollars . Cents

Multiply # of teachers x $80

Refreshment Fee - Each conventioneer is charged this fee for a continental breakfast (served Thursday and Friday mornings) and for refreshments throughout the convention.

This fee is required. Note that the refreshment fee is charged per person attending the convention; $3.25 for 2 days (not $3.25 each day).

Total Number Attending *

Refreshment fee is charged per staff member attending. The cost covers both days and assumes that all staff will have some refreshments during the convention.

x $3.25 = * $ Dollars . Cents

Multiply # attending x $3.25

Number of Lunches *Optional

Lunch is served at the Dordt Commons on Thursday.

x $6.25 = $ Dollars . Cents

Multiply # of lunches by $6.25

TOTAL = registration fee + refreshments fee + lunch * $ Dollars . Cents

Add fee + Refreshment fee + Optional Lunch

Attendees

Be sure to type the names correctly because they will be used for the name tags during the convention. After you have entered all your names, move to the bottom of the form to answer a few more questions.

If you have more than 24 teachers attending you may just attach the file in the next section.

Name (1) First Last

Lunch? (1)

Yes No

Name (2) First Last

Lunch? (2)

Yes No

Name (3) First Last

Lunch? (3)

Yes No

Name (4) First Last

Lunch? (4)

Yes No

Name (5) First Last

Lunch? (5)

Yes No

Name (6) First Last

Lunch? (6)

Yes No

Name (7) First Last

Lunch? (7)

Yes No

Name (8) First Last

Lunch? (8)

Yes No

Name (9) First Last

Lunch? (9)

Yes No

Name (10) First Last

Lunch? (10)

Yes No

Name(11) First Last

Lunch? (11)

Yes No

Name (12) First Last

Lunch? (12)

Yes No

Name (13) First Last

Lunch? (13)

Yes No

Name (14) First Last

Lunch? (14)

Yes No

Name (15) First Last

Lunch? (15)

Yes No

Name (16) First Last

Lunch? (16)

Yes No

Name (17) First Last

Lunch? (17)

Yes No

Name (18) First Last

Lunch? (18)

Yes No

Name (19) First Last

Lunch? (19)

Yes No

Name (20) First Last

Lunch? (20)

Yes No

Name (21) First Last

Lunch? (21)

Yes No

Name (22) First Last

Lunch? (22)

Yes No

Name (23) First Last

Lunch? (23)

Yes No

Name (24) First Last

Lunch? (24)

Yes No

If you have more than 24 attendees, attach a file below. Include each registrants full name and if they want lunch.

Attach a File

Attach a file with a list of attendees if you are registering more that 24 people.

and just a few more questions...

You're almost finished!

Total Number Attending *

Who completed this form? *

Email *

Make checks payable to CSI Heartland Christian Schools

Send Checks to:
Jodi Hulstein
Heartland Christian Schools
Dordt College
498 4th Ave NE
Sioux Center, IA 51250-1606

Heartland Christian Schools

Fee calculation instructions:

Refreshment Fee - Each conventioneer is charged this fee for a continental breakfast (served Thursday and Friday mornings) and for refreshments throughout the convention.

Attendees

If you have more than 24 attendees, attach a file below. Include each registrants full name and if they want lunch.

and just a few more questions...

Make checks payable to CSI Heartland Christian Schools

Registration deadline is September 20, 2011. Fees should be prepaid before the convention.