2024/08/7 Early Childhood Conference For additional information you can visit the event page here. Main Registrant InformationName* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix MiRegistry Number*If you have an MiRegistry Number (State of Michigan) please enter it here. If you do not enter 9999.Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee Email* Enter Email Confirm Email Phone Number*Phone Type* Mobile Home Work Home Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code School / Organization Name (e.g. "Trinity" or "St. Paul")*School / Organization City*Emergency Contact*Please provide a contact in case of emergency. This will be the contact for everyone registered on this registration. First Last Phone Number Registration DetailsThis field is hidden when viewing the formEarly Bird Registration Early Bird Early Childhood Conference 2024 Registration*Includes program and meal fee. Price: After June 30, 2024* Add $15 Number of Additional Attendees*If you would like to register and pay for additional attendees at this time on this order, please enter how many additional registrants you will be adding. Otherwise, choose "0".0123456789101112131415Additional Attendee Charge* Price: $35.00 Additional Attendees - Non Early Bird* Price: $45.00 2nd AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about sectional preferences, training hours, and SCECHs, as well as an end of conference survey.2nd Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 2nd Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 2nd Attendee Email* Enter Email Confirm Email MiRegistry Number (2nd Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.3rd AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.3rd Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 3rd Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 3rd Attendee Email* Enter Email Confirm Email MiRegistry Number (3rd Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.4th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.4th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 4th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 4th Attendee Email* Enter Email Confirm Email MiRegistry Number (4th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.5th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.5th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 5th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 5th Attendee Email* Enter Email Confirm Email MiRegistry Number (5th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.6th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.6th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 6th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 6th Attendee Email* Enter Email Confirm Email MiRegistry Number (6th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.7th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.7th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 7th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 7th Attendee Email* Enter Email Confirm Email MiRegistry Number (7th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.8th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.8th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 8th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 8th Attendee Email* Enter Email Confirm Email MiRegistry Number (8th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.9th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.9th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 9th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 9th Attendee Email* Enter Email Confirm Email MiRegistry Number (9th Attendee)This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.10th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.10th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 10th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 10th Attendee Email* Enter Email Confirm Email MiRegistry Number (10th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.11th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.11th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 11th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 11th Attendee Email* Enter Email Confirm Email MiRegistry Number (11th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.12th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.12th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 12th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 12th Attendee Email* Enter Email Confirm Email MiRegistry Number (12th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.13th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.13th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 13th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 13th Attendee Email* Enter Email Confirm Email MiRegistry Number (13th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.14th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.14th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 14th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 14th Attendee Email* Enter Email Confirm Email MiRegistry Number (14th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.15th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.15th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 15th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 15th Attendee Email* Enter Email Confirm Email MiRegistry Number (15th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.16th AttendeePlease complete each field for each registrant, including each person's position and individual email. This email will be used to communicate information about training hours and SCECHs, as well as an end of conference survey.16th Attendee* Mrs.MissMs.Mr.Rev.Dr.Rev. Dr.Prof.Dcs. Prefix First Last Suffix 16th Attendee Position* Early Childhood/Preschool Director Early Childhood/Preschool Teacher Early Childhood/Preschool Aide/Asst Kindergarten Teacher 1st Grade Teacher 2nd Grade Teacher Principal Speaker/Committee 16th Attendee Email* Enter Email Confirm Email MiRegistry Number (16th Attendee)*This is a number with the state of Michigan. Everyone may not have this number. If they don't have one please enter 9999.Additional InformationI/we will need a paper certificate for training hours and will pick up at the end of the conference. Yes No Special Dietary or Mobility Needs*Please note any dietary or mobility special needs. If none, please enter "N/A." Example: Travis is Gluten Free.Net Price Adjustment Price: $0.00 Sales Tax and PaymentsPaying with Org FundsThe District is required to collect and remit sales tax on certain sales in Michigan (tangible personal property, prepared food, etc.) unless a valid Michigan Sales and Use Tax Certificate of Exemption is on file at the District Office and funds are moving directly from the exempt organization (organization check or organization credit card). We are paying with an exempt organization's check, credit card, or PayPal account Sales Tax Information*Note: The Michigan District has exemption forms for nearly all congregations/schools of the Michigan District. Our Certificate of Exemption is on file with the District I will upload a new Certificate of Exemption today Upload Tax Exemption Form*You may download a fillable Michigan Sales and Use Tax Certificate of Exemption at https://www.michigan.gov/documents/taxes/3372_216612_7.pdf .Accepted file types: jpg, pdf, jpeg, png, gif, Max. file size: 50 MB.Sales Tax Price: $0.00 Total $0.00 Payment Method* PayPal or Credit/Debit Card Will mail in check Please make check payable to: Michigan District, LCMS Mail to: Michigan District, LCMS c/o Registrations 3773 Geddes Rd. Ann Arbor, MI 48105 CAPTCHA NOTE: If you are an EC Director and would like to also attend the EC Directors Day Event on August 6, 2024, you will also need to complete a separate registration. Please visit that event page to do so. Δ