Your Name:*          
 Street Address:*     
 City:*               
 State:*              
 Zip:*                
 E-Mail Address:*     
 Telephone number:*   
 Name and information for badge (chapter affliations, PAN):* 
 

Registration Fee Schedule:*		NEC Member	Non-NEC Member	
								

Registration 				$189		$199  
Guest/Spouse Meal Pass			$95		$95

First Time Attendee  Yes  No


Payment method:* PayPal  
                 Check

		  
If you are paying by check, please pay at Conference Registration


Registration refund policies and payment fees: After March 1, subject to $40 cancellation fee; 
after March 12, subject to $80 cancellation fee.  ($20 surcharge for returned checks)

Published in book-length fiction?   Yes    No

Published authors who wish to be included in the Literacy Booksigning, please check here. 


Please note: Agents and editors prefer to see only authors who have completed manuscripts.

Editor and Agent Appointment: 
First Choice:  
Second Choice: 

(One appointment per person.  Appointments made by order of registration/request.)
 
Please e-mail me about conference updates and future conferences.

 When done, please  or