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the summer inclusion cont is july 9/10 at montclair state university

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PLEASE DISTRIBUTE to YOUR NETWORKS:

The Summer Inclusion Conference is July 9 and 10 at Montclair State

University. The theme this year is linking students with disabilities to

the general education curriculum. There are keynotes and 7 workshops each

day, many of which parents/families would find useful. The workshops are

presented by entertaining, knowledgeable national and NJ experts.

NJCIE still has several parent scholarships available for one or two days.

Contact us for the form. 732-613-0400.

Full brochure is attached. Workshops include:

Keynote on July 9: What is in the Heart of Inclusion! By Vazquez and

Ari Ne'eman. These are young adults with disabilities ( has CP, Ari is

on the spectrum) who will inspire listeners re: their experiences with

inclusion.

Keynote on July 10: Reach for the Stars! Tilton, national expert on

differentiation. If you don't know what differentiation is all about, come

hear !

Membership, Participation and Learning for Students with Significant

Disabilities in Middle-High School General Education Classes, presented by

McSheehan from the University of New Hampshire

Meaningful Curricular Adaptations for Elementary Student with Complex Needs

and Can I Hang with You? Creating Connections Between Kids with and without

Disabilities by Kenna Colley, Radford University

Program Options for Supporting Students with Disabilities in General

Education, by Donna Bogart, Ed.D., NJ Department of Education, Office of

Special Education Programs

a S. Lieb, Esq, President & CEO

New Jersey Coalition for Inclusive Education

9 Auer Court, Suite H

East Brunswick, NJ 08816

(P) 732-613-0400

(F) 732-390-7696

njcie@...

http://njcie.net

A conference for

ALL teachers, administrators,

parents, pre-referral teams,

CST members, paraprofessionals,

related service professionals,

self-advocates, and others to

learn important skills to support

students with disabilities in

general education classrooms.

Connecting to the

General Education

Curriculum.

Life, Activities

and Peers!

Presented by:

New Jersey Coalition

for Inclusive Education, Inc.

District co-sponsor:

West New York School District

NJ Education Association,

National Down Syndrome Society,

NJ Department of Education-

Office of Special Education Programs,

NJ Association of School Psychologists,

The Arc of New Jersey,

NJ Association of Speech Language Specialists,

NJ Speech-Language-Hearing Association,

NJ Council on Developmental Disabilities,

Statewide Parent Advocacy Network.

NJCIE Summer Inclusion Conference 2008 Location:

THE CONFERENCE CENTER, Montclair State University (MSU) University Hall, 7th

Floor, 1 Normal Avenue, Montclair, NJ 07043

NJCIE's 6th Annual

Summer Inclusion

Conference, 2008

,

West New York School District

July 9 & 10, 2008

CONFERENCE SCHEDULE:

Wednesday, July 9th and Thursday, July 10th

Registration and Continental Breakfast Begin at 8:30 am

Welcome and Keynote 9:30 am

Session I Workshops (A.M.) 10:30 am-12:30 pm

Lunch 12:40 pm-1:20 pm

Session II Workshops (P.M.) 1:30 pm-3:30 pm

JULY 9th KEYNOTE:

Helena Vazquez

and Ari Ne'eman

TWO IMPRESSIVE YOUNG adults

with disabilities who graduated from

New Jersey's public schools will share

their thoughts about their experiences

with inclusion and their insights into

how schools can help students

connect to life, activities and peers.

1) Tools for Tomorrow: Teacher Friendly Strategies for Connecting

All Students to Content Standards: How can all students meet New Jersey's

Core Curriculum Content Standards in an inclusive classroom? Dr. Amerman

will

provide real examples from New Jersey classrooms meeting that challenge. She

will also provide strategies and tools that teachers can implement

immediately in

their classrooms to motivate struggling learners, foster academic

independence,

and meet the challenge of New Jersey's high stakes testing standards.

Presenter: Amerman, Assistant Professor, NJ City University

2) Membership, Participation and

Learning for Students with Significant

Disabilities in Middle - High

School General Education Classes:

There is a growing body of research

on teaching students with significant

disabilities academic content in Middle

and High Schools. Policy mandates

require that students with significant

disabilities demonstrate academic

content learning via alternate assessments.

How does this research

translate into practice in the general

education classroom? How can the

research and practice innovations

help succeed with alternate assessment? What supports need to be in place

for this to happen? This session will translate the most recent advances in

inclusive education research for students with significant disabilities into

practical application in the classroom and in alternate assessments.

Examples

will emphasize students with labels of autism, multiple disabilities;

intellectual

and other developmental disabilities in general education classrooms

learning

general education academics.

Presenter: McSheehan, Clinical Assistant Professor of Communication

Sciences and Disorders at the University of New Hampshire

3) Meaningful Curricular Adaptations for Elementary Students

with Complex Needs within a Standardized Curriculum: Academic learning

is the vehicle for participation in classrooms. Learn how students with

complex

needs in grades K-6 can be actively included in classroom instruction via

creative adaptations.

Presenter: Kenna M. Colley, Radford University, Radford, Virginia

4) Paraprofessionals: Maximizing the Possibilities and Avoiding the

Pitfalls:

Paraprofessionals are one of the most utilized supports in schools yet their

assets are often untapped or used incorrectly. Learn how to maximize this

valuable resource in the classroom, to support teachers and students.

Presenter: Orah Raia, NJCIE Speakers' Bureau Consultant

5) Sharing Real Experiences, Great Ideas: An Interactive Workshop for

Teachers: Developing communities of learning among teachers is crucial if we

hope to embed inclusive practices in our schools. This workshop will feature

early childhood and upper elementary teachers from two New Jersey elementary

schools which have won fellowship awards in inclusive practices from the New

Jersey Council on Developmental Disabilities. The teachers will share

strategies

and ideas which have worked well in their classrooms of diverse learners,

then

open the floor for an interactive sharing among all of the teachers,

including

those in the audience. Pick up some great ideas from your colleagues.

Presenters: Teachers from the Early Childhood Center-Hamilton Terrace

Elementary School, Berkeley Heights School District and a second elementary

school to be announced.

6) Practical Applications of Positive Behavior Support (PBS)

in the Classroom: The behavioral challenges of students impact the job

satisfaction

of over 80% of teachers. However, many interventions used currently

in New Jersey classrooms are neither research-based nor teacher-friendly.

Participants will receive an overview of the empirically valid principals of

positive

behavior support and discuss practical behavior intervention strategies

based

on these principals. Strategies include using strategies to prevent

behaviors

that interfere with instruction, teaching replacements for students'

interfering

behaviors, and encouraging appropriate student behavior through

reinforcement.

Presenter: Lockwood, Positive Behavior Support Specialist, NJCIE

7) Integration of Assistive Technology in the Educational Process: Specific

Performance Areas where best practices have indicated Assistive Technology

may have an impact on students with disabilities will be defined. A

framework

for decision-making, centered on the IEP process, will provide the necessary

structure for complying with IDEA through the systematic consideration of

Assistive Technology devices and services. Examples of Assistive Technology

available for each Performance Area will be covered. Attendees will be

provided

a resource guide for implementation of the concepts and practices presented.

Presenter: Bud Rizer, AT Support Team, Office of Education, Department of

Children and Families

Wednesday

July 9th

A.M.

SESSION

P.M.

SESSION

Workshop One

Workshop Two

Workshop Three

Workshop Four

Workshop Five

Workshop Six

Workshop Seven

1) Differentiating Instruction in a

Diverse Classroom (AM ONLY): In this

session, Tilton, will expand upon and

answer questions about the ideas introduced

in her keynote, described above.

2) Program Options for Supporting

Students with Disabilities in General

Education (AM ONLY): An array of

program options for supporting students

with disabilities in general education programs, including the use of

consultation,

teacher aides, integrated therapies, supplemental instruction, and resource

programs will be presented.

Presenter: Donna S. Bogart, Special Education Consultant, NJDOE-OSEP,

LRC-North

3) Assessing and Influencing School Climates to promote Inclusion:

This workshop is designed to heighten awareness and promote discussion about

the critical nature of School Climates and Culture that have a direct

influence on

successful inclusion of all students. There will be an attempt to build a

conceptual

framework with the participants reflecting an understanding and analysis of

school climates and culture. Theory and practice in whole school reform;

positive school-wide approaches to behavior; the building of positive /

supportive environments for academic and social learning will be used.

Presenter: Jerry G. Petroff, Assistant Professor, The College of New Jersey

4) Supporting Students Who Use Oppositional and Inflexible Behaviors

Through Collaborative Problem Solving: Often the behaviors of students with

emotional needs due to mental health issues, autism spectrum disorders and

other disabilities may appear to be

oppositional and defiant in nature when

they are actually driven by anxiety,

low-self esteem, and poor social skills.

Participants will discuss the differences

and apparent commonalities

among the behaviors of students who

are described as " inflexible " and those

who are viewed as being " oppositional "

and carry away strategies for avoiding

power struggles.

Presenter: Lockwood,

Positive Behavior Support Specialist,

NJCIE

5) Standards to Practice - Turning Standards-Based Education into

ative

Inclusive Education: Learn a process of curriculum development using

the NJ Core Curriculum Standards. This presentation is based upon the

presenter's

successful teaching practice in inclusive Science classrooms. A particular

focus is given to thematic unit production and multiple intelligence theory.

Presenter: , Assistant Principal, stown School District, New

York

6) Can I Hang With You? Creating Connections between Kids with and

without Disabilities: Facilitating positive peer relationships is essential

to the

development of successful inclusive classrooms. This workshop focuses on

relationship

building ideas, challenges, strategies for children with and without

disabilities,

along with problem solving around common relationship issues in schools.

Presenter: Kenna M. Colley,

Radford University, Virginia

ADMINISTRATORS' STRAND

7) Leadership, Change and Inclusive

Schools (AM ONLY): This workshop will

examine the process and practice to

bring about school and district change

when developing and maintaining an

inclusive program. Discussion will include

organizational challenges associated

with the change process and the

role of school leaders. This session will

be co-presented by two former NJ

school superintendents who have spent

many years working in the field of organizational

change and inclusive education.

Presenters: Bastardo, Senior Associate, RIISA, Graduate School of

Education, Rutgers University; Snyder, former Superintendent of

Schools, Freehold Township NJ

ADMINISTRATOR'S STRAND

8) In-Class Resource Program Instruction: Overview for Administrators

(PM ONLY): In-class resource program instruction is one option for

supporting

students with disabilities in the general education curriculum within the

general

education classroom. Designed for administrators, this session will provide

an

overview of in-class resource program instruction with a focus on the

following

areas: 1) student characteristics; 2) co-teacher roles and responsibilities;

3) instructional arrangements; and, 4) administrator's role in

implementation.

Presenter: Donna S. Bogart, Special Education Consultant, NJDOE-OSEP,

LRC-North

JULY 10th KEYNOTE:

Reach for the Stars!

with Tilton

HOW TO DIFFERENTIATE INSTRUCTION in Today's Diverse Classroom. Welcome to a

celebration of tools, tips and

techniques to use in differentiating instruction! This highly practical

keynote session is filled with dozens of

" take back and use " ideas to help every student succeed! The ideas suggested

are time-efficient and extremely

effective. Specific strategies will help students get organized, be

accountable for results, compensate for

difficulties, and improve reading, math, and writing skills. This session

includes ideas for all grade levels and

content areas. In each topic area listed, will suggest many concrete

strategies. These are the " nuts and

bolts " ideas that you will take back and use immediately!

Thursday

July 10th

A.M.

SESSION

P.M.

SESSION

Workshop One

Workshop Two

Workshop Three

Workshop Four

Workshop Five

Workshop Six

Workshop Seven

Workshop Eight

A Note to Educators & Parents: All workshops are

interactive and cover topics identified by teachers,

administrators and other educational professionals as

most needed to improve instruction and support inclusive

educational practices in their schools. Parents are

welcome to attend any sessions which interest them!

Location: Set on the seventh story of University Hall,

The Conference Center has a million-dollar panoramic view

of the Manhattan skyline that will leave you breathless.

The MSU campus is easily accessible by car from the

Garden State Parkway, the New Jersey Turnpike, Route 46;

by bus from several locations; by train from New York City

(train station on campus). See below for Directions.

http://www.montclair.edu/welcome/directions.html.

Directions: MSU is located at 1 Normal Avenue, Montclair, NJ, USA 07043.

*Please note, when using online or GPS mapping systems, use 30 East Normal

Avenue as your

destination, (directly across from the main entrance). The Conference Center

is located on

the 7th Floor of: University Hall (Building #51) - The College of Education

and Human Services.

Campus Map: http://www.montclair.edu/welcome/campustour/campusmap300dpi.jpg.

Registration includes all fees: NJCIE professional development programs are

designed to

satisfy the criteria and state requirements for travel by school district

personnel.

Registration: See the registration form for details. Registration will open

at 8:30 A.M. at

The Conference Center (7th Floor of: University Hall (Building #51) - The

College of Education

and Human Services). Spots may be available for on-site registration, but

you must call NJCIE

at 732-613-0400 by Tuesday, July 1, 2008 to determine if spaces are still

available.

Refunds: Conference plans and expenses are based on pre-registration. No

refunds awarded

after June 1, 2008. However, substitutions are permitted with prior approval

by NJCIE.

Local Hotels: Information about hotels close to the MSU campus may be found

at

http://www.montclair.edu/local/staying.html.

Professional Development Hours: NJCIE is a registered continuing education

provider

(#4273) by the NJ Department of Education. Professional development

certificates will be

available attended workshops. (5 hrs / day). This conference is a NJEA

approved event.

Discounted Conference Fees: Discounts are available for current NJCIE

members and for

school-based teams of 2 or more people from one school registering for both

days. Registrations

must be received in the same envelope. See the enclosed registration form

for details.

Achieve Through Inclusion

L inda Tilton is an international author,

speaker and educational consultant with 35

years in the field of education. She is best known for

her highly practical " take back and use " strategies

designed to help every student succeed. believes

passionately that today's engaged student is tomorrow's

lifelong learner. She is the author of several

books including The Teacher's Toolbox for Differentiating Instruction

and

Inclusion: A Fresh Look. She has created two staff development kits and

the video, Choosing to Change. All of her materials share 's enthusiasm

for learning and life. She is a true champion of student success!

K enna M. Colley, is an Assistant Professor

in the College of Education and Human

Development at Radford University in Radford, Virginia

and the Co-director for its Training and Technical

Assistance Center. She facilitates systems change

within public schools (K-12) throughout southwest

Virginia via long-term technical assistance. Kenna

has worked as an educator supporting students with disabilities in

general education classrooms in preschool, elementary and middle

school settings, along with working in adult services and administration.

She is an active presenter at state and national conferences on

collaboration, best practices in inclusive settings, positive behavioral

supports and peer supports for students with disabilities. Kenna

has appeared in the HBO documentary " Educating " and has

contributed to several books on inclusive education.

M ichael McSheehan is

Clinical Assistant Professor of

Communication Sciences and Disorders at the

University of New Hampshire (UNH) and a Project

Associate with UNH's Institute on Disability/

UCED. Mr. McSheehan's primary area of interest

is the learning of general education curriculum in

the general education classroom by students with significant (cognitive)

disabilities. He presently coordinates two federally funded projects

on alternate assessment. From research conducted during a 4-year

project, Beyond Access, he co-authored three peer-reviewed articles

about the Beyond Access Model, high expectations, and learning of

academic content by students with significant disability labels.

is past Chair of the TASH Education Committee, guest faculty

in UNH's Inclusion Facilitator Program, faculty member for the Annual

NH Summer Institute on Autism and the NH Resource Center on

Autism Spectrum Disorders, presents internationally at professional

conferences and for family organizations.

JULY

9

JULY

10

JULY

9 & 10

Nationally Recognized

PRESENTERS

A Note to Educators & Parents: All workshops are

interactive and cover topics identified by teachers,

administrators and other educational professionals as

most needed to improve instruction and support inclusive

educational practices in their schools. Parents are

welcome to attend any sessions which interest them!

Location: Set on the seventh story of University Hall,

The Conference Center has a million-dollar panoramic view

of the Manhattan skyline that will leave you breathless.

The MSU campus is easily accessible by car from the

Garden State Parkway, the New Jersey Turnpike, Route 46;

by bus from several locations; by train from New York City

(train station on campus). See below for Directions.

http://www.montclair.edu/welcome/directions.html.

Directions: MSU is located at 1 Normal Avenue, Montclair, NJ, USA 07043.

*Please note, when using online or GPS mapping systems, use 30 East Normal

Avenue as your

destination, (directly across from the main entrance). The Conference Center

is located on

the 7th Floor of: University Hall (Building #51) - The College of Education

and Human Services.

Campus Map: http://www.montclair.edu/welcome/campustour/campusmap300dpi.jpg.

Registration includes all fees: NJCIE professional development programs are

designed to

satisfy the criteria and state requirements for travel by school district

personnel.

Registration: See the registration form for details. Registration will open

at 8:30 A.M. at

The Conference Center (7th Floor of: University Hall (Building #51) - The

College of Education

and Human Services). Spots may be available for on-site registration, but

you must call NJCIE

at 732-613-0400 by Tuesday, July 1, 2008 to determine if spaces are still

available.

Refunds: Conference plans and expenses are based on pre-registration. No

refunds awarded

after June 1, 2008. However, substitutions are permitted with prior approval

by NJCIE.

Local Hotels: Information about hotels close to the MSU campus may be found

at

http://www.montclair.edu/local/staying.html.

Professional Development Hours: NJCIE is a registered continuing education

provider

(#4273) by the NJ Department of Education. Professional development

certificates will be

available attended workshops. (5 hrs / day). This conference is a NJEA

approved event.

Discounted Conference Fees: Discounts are available for current NJCIE

members and for

school-based teams of 2 or more people from one school registering for both

days. Registrations

must be received in the same envelope. See the enclosed registration form

for details.

NOTE: Parking in the Red Hawk Campus Parking Facility is $5.00

Achieve Through Inclusion

L inda Tilton is an international author,

speaker and educational consultant with 35

years in the field of education. She is best known for

her highly practical " take back and use " strategies

designed to help every student succeed. believes

passionately that today's engaged student is tomorrow's

lifelong learner. She is the author of several

books including The Teacher's Toolbox for Differentiating Instruction and

Inclusion: A Fresh Look. She has created two staff development kits and

the video, Choosing to Change. All of her materials share 's enthusiasm

for learning and life. She is a true champion of student success!

K enna M. Colley, is an Assistant Professor

in the College of Education and Human

Development at Radford University in Radford, Virginia

and the Co-director for its Training and Technical

Assistance Center. She facilitates systems change

within public schools (K-12) throughout southwest

Virginia via long-term technical assistance. Kenna

has worked as an educator supporting students with disabilities in

general education classrooms in preschool, elementary and middle

school settings, along with working in adult services and administration.

She is an active presenter at state and national conferences on

collaboration, best practices in inclusive settings, positive behavioral

supports and peer supports for students with disabilities. Kenna

has appeared in the HBO documentary " Educating " and has

contributed to several books on inclusive education.

M ichael McSheehan is

Clinical Assistant Professor of

Communication Sciences and Disorders at the

University of New Hampshire (UNH) and a Project

Associate with UNH's Institute on Disability/

UCED. Mr. McSheehan's primary area of interest

is the learning of general education curriculum in

the general education classroom by students with significant (cognitive)

disabilities. He presently coordinates two federally funded projects

on alternate assessment. From research conducted during a 4-year

project, Beyond Access, he co-authored three peer-reviewed articles

about the Beyond Access Model, high expectations, and learning of

academic content by students with significant disability labels.

is past Chair of the TASH Education Committee, guest faculty

in UNH's Inclusion Facilitator Program, faculty member for the Annual

NH Summer Institute on Autism and the NH Resource Center on

Autism Spectrum Disorders, presents internationally at professional

conferences and for family organizations.

JULY

9

JULY

10

JULY

9 & 10

Nationally Recognized

PRESENTERS

A Note to Educators & Parents: All workshops are

interactive and cover topics identified by teachers,

administrators and other educational professionals as

most needed to improve instruction and support inclusive

educational practices in their schools. Parents are

welcome to attend any sessions which interest them!

Location: Set on the seventh story of University Hall,

The Conference Center has a million-dollar panoramic view

of the Manhattan skyline that will leave you breathless.

The MSU campus is easily accessible by car from the

Garden State Parkway, the New Jersey Turnpike, Route 46;

by bus from several locations; by train from New York City

(train station on campus). See below for Directions.

http://www.montclair.edu/welcome/directions.html.

Directions: MSU is located at 1 Normal Avenue, Montclair, NJ, USA 07043.

*Please note, when using online or GPS mapping systems, use 30 East Normal

Avenue as your

destination, (directly across from the main entrance). The Conference Center

is located on

the 7th Floor of: University Hall (Building #51) - The College of Education

and Human Services.

C ampus Map:

http://www.montclair.edu/welcome/campustour/campusmap300dpi.jpg.

Registration includes all fees: NJCIE professional development programs are

designed to

satisfy the criteria and state requirements for travel by school district

personnel.

Registration: See the registration form for details. Registration will open

at 8:30 A.M. at

The Conference Center (7th Floor of: University Hall (Building #51) - The

College of Education

and Human Services). Spots may be available for on-site registration, but

you must call NJCIE

at 732-613-0400 by Tuesday, July 1, 2008 to determine if spaces are still

available.

Refunds: Conference plans and expenses are based on pre-registration. No

refunds awarded

after June 1, 2008. However, substitutions are permitted with prior approval

by NJCIE.

Local Hotels: Information about hotels close to the MSU campus may be found

at

http://www.montclair.edu/local/staying.html.

Professional Development Hours: NJCIE is a registered continuing education

provider

(#4273) by the NJ Department of Education. Professional development

certificates will be

available attended workshops. (5 hrs / day). This conference is a NJEA

approved event.

Discounted Conference Fees: Discounts are available for current NJCIE

members and for

school-based teams of 2 or more people from one school registering for both

days. Registrations

must be received in the same envelope. See the enclosed registration form

for details.

NOTE: Parking in the Red Hawk Campus Parking Facility is $5.00

Achieve Through Inclusion

L inda Tilton is an international author,

speaker and educational consultant with 35

years in the field of education. She is best known for

her highly practical " take back and use " strategies

designed to help every student succeed. believes

passionately that today's engaged student is tomorrow's

lifelong learner. She is the author of several

books including The Teacher's Toolbox for Differentiating Instruction

and

Inclusion: A Fresh Look. She has created two staff development kits and

the video, Choosing to Change. All of her materials share 's enthusiasm

for learning and life. She is a true champion of student success!

K enna M. Colley, is an Assistant Professor

in the College of Education and Human

Development at Radford University in Radford, Virginia

and the Co-director for its Training and Technical

Assistance Center. She facilitates systems change

within public schools (K-12) throughout southwest

Virginia via long-term technical assistance. Kenna

has worked as an educator supporting students with disabilities in

general education classrooms in preschool, elementary and middle

school settings, along with working in adult services and administration.

She is an active presenter at state and national conferences on

collaboration, best practices in inclusive settings, positive behavioral

supports and peer supports for students with disabilities. Kenna

appeared in the HBO documentary " Educating " and has

contributed to several books on inclusive education.

M ichael McSheehan is

Clinical Assistant Professor of

Communication Sciences and Disorders at the

University of New Hampshire (UNH) and a Project

Associate with UNH's Institute on Disability/

UCED. Mr. McSheehan's primary area of interest

is the learning of general education curriculum in

the general education classroom by students with significant (cognitive)

disabilities. He presently coordinates two federally funded projects

on alternate assessment. From research conducted during a 4-year

project, Beyond Access, he co-authored three peer-reviewed articles

about the Beyond Access Model, high expectations, and learning of

academic content by students with significant disability labels.

is past Chair of the TASH Education Committee, guest faculty

in UNH's Inclusion Facilitator Program, faculty member for the Annual

NH Summer Institute on Autism and the NH Resource Center on

Autism Spectrum Disorders, presents internationally at professional

conferences and for family organizations.

JULY

9

JULY

10

JULY

9 & 10

Nationally Recognized

PRESENTERS

SUMMER 2008 INCLUSIVE EDUCATION CONFERENCE

Connecting to General Education

Curriculum.Life, Activities, Peers

July 9th & July 10th, 2008 8:30am - 3:30pm

.. ALL CURRENT STUDENTS (ID Required).$40 registration fee.

.. Please Note, NJCIE Individual Memberships are available at an annual fee

of $35.

Organizational Memberships are $100. annually, and entitle those registering

as a

member of a team from that organization, to a discount as indicated above.

.. NO REFUNDS - Conference plans & expenses are based on pre-registration.

If you must cancel, we regret that we cannot offer refunds or release

purchase

orders after June 1, 2008.

.. Registration closes July 1, 2008.

ONE FORM PER PERSON

Please Print Clearly

FIRST NAME: ______________________________

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THE ADDRESS YOU HAVE PROVIDED IS YOUR

WORK / HOME (CIRCLE ONE):

ADDRESS: _________________________________

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STATE: ____________________________________

ZIP: _______________________________________

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WK. PH. ___________________________________

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MAKE SURE IT IS ACTIVE & LEGIBLY WRITTEN.

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AFFILIATION: _______________________________

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_______ PROFESSIONAL

IF EDUCATOR,

PLEASE SPECIFY

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NJCIE MEMBERS ONLY!

Circle the Appropriate Choice

EARLY

BIRD BY

June 1st

AFTER

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Individual Member, Both Days $190 $215

Organization Member Team, Both Days

[2 or more members, attending both days].

Registrations must be submitted together.

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Circle the Appropriate Choice

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2 or more people, attending both days].

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9 AUER COURT, SUITE H

EAST BRUNSWICK, NJ 08816

NJCIE PHONE 732-613-0400 NJCIE FAX 732-390-7696

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