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Registration Information
Teachers of Struggling Students in Math
A Conference for School Administrators

Complete the form below to register for our conferences
First Name:
Last Name:
Position:
School Name:
School Address:
City/State:
School Phone:
Home Phone:
Email Address:
Note: Registration confirmations are sent by e-mail
Conference Location:
Method of Payment
Payment is due prior to conference - $175.00 per person
Number of People Attending
Attach List of Attendee Names (if more than one):
check (payable to Mathematical Systems, Inc. is attached)
Purchase order is attached, P.O. #
Mail check or P.O. with this form to:
Mathematical Systems, Inc.
P.O. Box 82040, Las Vegas, NV 89180
Charge my credit card:
Acc’t # Exp. Date (MMYY)
CVV2 (verification on back of card)
Name on card:
Pre-registration required
due to limited enrollment
FOUR EASY WAYS TO REGISTER:

Complete this form

- OR -
PHONE: 800.218.5482
- OR -
FAX this form to: 702.431.2521
- OR -
MAIL this form to:
Mathematical Systems, Inc.
P.O. Box 82040
Las Vegas, NV 89180

Teachers of Struggling
Students in Mathematics

Tucson, AZ
May 12, 2011
8 am - 3 pm
Clarion Hotel--Airport
6801 S. Tucson Blvd.



WHO SHOULD ATTEND
School Administrators, Classroom Teachers, Curriculum Directors, Department Heads, and Professional Developers serving grades 5 through 12.