2024 IDEA Academy Registration
Please complete the form below.
Full Name
*
First Name
Last Name
First Name as it should appear on Badge
Title
*
Agency
*
E-mail
*
example@example.com
Confirm E-mail
*
example@example.com
Work Phone
*
Please enter a valid phone number.
Cell Phone
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Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
A contact list will be shared with attendees after the program.
I agree to be listed.
Opt out (Do not list my name or contact information on the contact list.)
Conference Fees for Individual Participant
Main Conference - July 10-12 - $1,495.00
Add-on Basics Day - July 9 - $200
Conference Fees for Group Participants (limited to sponsored participation by State Agency, 6+ attendees)
Main conference - July 10-12 - $1,250.00
Add-on Basics Day - July 9 - $200
Participant
*
Individual
Group Participant
Payment Method
*
Check – Submit form. Make check payable to Special Education Solutions, LLC, Att: Deusdedi Merced, P.O. Box 1032, Weston, CT 06883.
Credit Card – Complete Fee Schedule Below. Submit form. Complete Payment page.
Group Participant – State Agency Administrator making payment. Submit form.
Pay by Credit Card
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Main Conference - July 10-12, 2024
Individual
$
1,495.00
Add-on Basics Day - July 9, 2024
Individual
$
200.00
Group Registration - Main Conference - July 10-12, 2024
Sponsored Participation by State Agency for 6 or more attendees
$
1,250.00
Quantity
1
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Group Registration - Add-on Basics Day - July 9, 2024
Sponsored Participation by State Agency for 6 or more attendees
$
200.00
Quantity
1
2
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5
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9
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Payment Method
*
Individual Participant paying by check or credit card.
Sponsored Group Participation/Agency paying by check or credit card.
Sponsored Group Participation/Individual payment - I am part of a group and am paying by check or credit card individually.
Credit Card - Complete Fee Schedule above and submit form. Complete Payment page after submitting form.
Payment Method
*
Individual Participant paying by check.
Sponsored Group Participation/Agency paying by check.
Sponsored Group Participation/Individual payment - I am part of a group and am paying by check individually.
Individual Participant paying by credit card.
Sponsored Group Participation/Agency paying by credit card.
Sponsored Group Participation/Individual payment - I am part of a group and am paying by credit card individually.
Payment Methods
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