Registration Form - New York State English Council

Attendees Must Register Online. Use Form Below.

Pay with PayPal or any Major Credit Card Via PayPal or by PO/Check.

School/ Institution*
School/Institution Address*
Street Address City State ZIP Code
Best Contact Email*
How many people are you registering? Select Here*
Registrant #1
Registrant #1 Name
First Last
Registrant #1 Position
Registrant #1 Email
Registrant #1 Conference Registration
Registrant #1 Conference Registration Retiree
Registrant #1 Conference Registration Pre-Service
Registrant #1 Awards Luncheon Only
Registrant #2
Registrant #2 Name
First Last
Registrant #2 Position
Registrant #2 Email
Registrant #2 Conference Registration
Registrant #2 Conference Registration Retiree
Registrant #2 Conference Registration Pre-Service
Registrant #2 Awards Luncheon Only
Registrant #3
Registrant #3 Name
First Last
Registrant #3 Position
Registrant #3 Email
Registrant #3 Conference Registration
Registrant #3 Conference Registration Retiree
Registrant #3 Conference Registration Pre-Service
Registrant #3 Awards Luncheon Only
Registrant #4
Registrant #4 Name
First Last
Registrant #4 Position
Registrant #4 Email
Registrant #4 Conference Registration
Registrant #4 Conference Registration Retiree
Registrant #4 Conference Registration Pre-Service
Registrant #4 Awards Luncheon Only
Registrant #5
Registrant #5 Name
First Last
Registrant #5 Position
Registrant #5 Email
Registrant #5 Conference Registration
Registrant #5 Conference Registration Retiree
Registrant #5 Conference Registration Pre-Service
Registrant #5 Awards Luncheon Only
Registrant #6
Registrant #6 Name
First Last
Registrant #6 Position
Registrant #6 Email
Registrant #6 Conference Registration
Registrant #6 Conference Registration Retiree
Registrant #6 Conference Registration Pre-Service
Registrant #6 Awards Luncheon Only
Registrant #7
Registrant #7 Name
First Last
Registrant #7 Position
Registrant #7 Email
Registrant #7 Conference Registration
Registrant #7 Conference Registration Retiree
Registrant #7 Conference Registration Pre-Service
Registrant #7 Awards Luncheon Only
Payment
Total
$0.00
I am Paying Via:
- PayPal /Major Credit Card thru PayPal
- PO/Check
Billing Information
Billing Name
First Last
Billing Address
Street Address City State ZIP Code
Billing Email
Payment Via PO/Check
Click here for NYSEC Form W9 pdf format
PO# and PO Upload
NOTE: PO# and PO can be emailed at a later date, if desired. Please email to: nysecteach@gmail.com
PO #
PO Upload submit these file types: .doc or .pdf
Drop files here or

Accepted file types: doc, pdf.
A copy will of this form
will be emailed to you.
Please include a copy of this form.
Make check payable to: NYSEC
Mail to: NYS English Council
18 Hidden Drive
Monroe, New York 10950

Attendees Must Register Online. Use Form Below.

Pay with PayPal or any Major Credit Card Via PayPal or by PO/Check.

Registrant #1

Registrant #2

Registrant #3

Registrant #4

Registrant #5

Registrant #6

Registrant #7

Payment

Billing Information

Payment Via PO/Check

PO# and PO Upload