Registration Form
Please complete the registration form below. To see full event details, search for the LTC event profile page at
ltcillinois.org/events
. Questions regarding registration can be directed to events@ltcillinois.org.
Event Details
Event Name
Location
Start Date
Start Time
Event Fee
$
Unfortunately the capacity for this event has been reached
. At this time we are
not
accepting registrations for our waitlist.
Unfortunately the capacity for this event has been reached
. At this time we are accepting registrations for our waitlist. Complete the form below to be added to our waitlist, and we will contact you if a spot opens up.
This event has been canceled.
Please contact events@ltcillinois.org with questions.
Registration is closed.
Organization
Type of Organization
Illinois Education Organization (i.e., school district, private school, ROE/ISC, association, etc.)
Non-Illinois Education Organization
Vendor
Independently Employed or Retired
Select Your Organization
If your institution is not listed, it may be included under a different name. To request an Illinois organization be added to the list, please email support@ltcillinois.org.
Name of Vendor or Non-Illinois Organization
Address
City
State
Zip
Contact Details
First Name
Last Name
Phone Number
Email
** ReType Email
Job Title
Primary Performance Responsibility
Please select...
Technology Leader
Technology Support Staff
Instructional Technology Leader
District Leader
Building Administrator
Teacher
Curriculum/Instruction Leader
Instructional Coach
PD Staff
Librarian or Media Leader
Special Education Leader
Business Officials
Facility Manager
Counselor
Support Staff
Consultant
Vendor/Sales Representative
Other
Unknown
IEIN Number
Billing
Billing
Please select...
Invoice my Organization
Invoice Me
Pay with Credit Card
Please provide your home address.
Please provide your district billing address.
Billing Contact Name
Billing Contact Email
Address
City
State
Zip
Cardholder Full Name (First and Last)
Cardholder Email Address
Credit Card Number
Expiration Date Month
Expiration Date Year
CVV
Additional Details
Cancelation/Refund Policy.
I acknowledge that all cancelation requests must be made in writing and sent to events@ltcillinois.org. A 100% refund will be granted when the cancellation request is received at least 24 hours before the event. Attendees who pay with credit cards will be refunded the full amount minus a 3% processing fee. No refund will be granted if the request is received less than 24 hours in advance. If LTC cancels the event, attendees that paid with credit card will receive a 100% full refund.
Newsletter.
Please sign me up for the LTC communications.
EventID
Email Doesn't Match Message
Success
Default Email Validation Text
Conditional Picker
Please select...
a
b
c
Registration Cost
Please select...
free
paid
Target Audience
Please select...
Parent
Other
Account - Assigned for Manual Review
Account - Independent/Retired
Account - Illinois Org ID
AccountId
LTC Event Website Confirmation Page
Event Status