BASA Events Update 12.14.18

REGISTRATION INFORMATION (PLEASE READ): • There will be 375 available spots at this Summit. Registrations will be taken on a first come, first serve basis. - A maximum of (5) people may attend from a district. - OASSA will communicate via email and social media once the 375 spots have been filled. - A wait list will form after the spots have been filled in the event of cancellations. • Attendees DO NOT have to be members of OASSA. • This conference is directed at those in AP Program Leadership or Administrative positions. • Registration for this Summit will begin on Monday, November 26, 2018. • The cost for this Summit is $100/attendee.

OASSA REGISTRATION FORM - Ohio Advanced Placement Success Summit • January 29, 2019 Renaissance Columbus Westerville-Polaris Hotel

Name and Email of person completing form:

District Name:

County:

Attendee #1 Name: Attendee #1 School:

Attendee #1 Position: Attendee #1 Email:

Attendee #2 Name: Attendee #2 School:

Attendee #2 Position: Attendee #2 Email:

Attendee #3 Name: Attendee #3 School:

Attendee #3 Position: Attendee #3 Email:

Attendee #4 Name: Attendee #4 School:

Attendee #4 Position: Attendee #4 Email:

Attendee #5 Name: Attendee #5 School:

Attendee #5 Position:

Attendee #5 Email: REGISTRATION FEE : $100 per attendee ( Registration fee includes: lunch and materials).

REGISTRATION & PAYMENT OPTIONS (Payment or purchase order must be included with your completed registration form - make checks payable to OASSA) : 1) Fax to the OASSA office at 614.430.8315 2) Email to Barb Benson at BBenson@oassa.org 3) Mail to the OASSA office: 8050 N High St., Suite 180, Columbus, OH 43235 Purchase Order # ___________________________ * Refunds will not be given but substitutions are allowed. _____ Please check here if you are disabled and require special services or have dietary needs. Attach a written description of needs. Card # _________________________________________________ Exp. Date _______________ Amount $ ____________ Card Billing Address ____________________________________________________________________________________ Street City Zip Email Receipt to: _______________________________________________________________________________________ MC/VISA/DISCOVER/AMERICAN EXPRESS (do not email sensitive credit card info; phone or fax is acceptable)