Oregon Association of Student Councils

Please fill out this form and submit it online or print it and send with payment to:

OASC
707 13th Street SE, Suite 100
Salem, OR, 97301-4035

Advisor Name:
Position:
School:
Address:
City, ZIP:
Phone number (with area code):
FAX number (with area code):
E-mail
Conference Fees:
"Early-bird gets the worm" (by October 2)
@ $100.00 per person (October 7-8, 2010) = $
@ $85 per person (Friday only - October 8th) = $
"All good things must come to an end" after October 2
@ $120.00 per person (October 7-8, 2010) = $
@ $105.00 per person (Friday only October 8th) = $
"The more the merrier" Bring a team of 3 or more and register before October 2nd
@ $90.00 per person (October 7-8, 2010) = $
@ $75.00 per person (Friday only October 8th) = $

Advisor Name:
Position:
Advisor Name:
Position:
Advisor Name:
Position:
Advisor Name:
Position
Number of participants @ $ = $
TOTAL AMOUNT DUE:	$
PAYMENT METHOD:	Enclosing Payment (print and mail this form) Bill School, P.O.# Bill District, P.O.#
If you have a Purchase Order number and wish to be invoiced, you may submit this form online.
Security Code:
Please enter the security code you see above in this box:

If you would like to send payment with your membership form, please print this form and mail to the address below.

Mail to: OASC 707 13th Street SE, Suite 100 Salem, OR 97301-4035

Questions? Contact Nancy Moen, Program Director
or call 503-480-7206.