2017 PAIU Conference Registration

Attendee Name*

First Name

Last Name

Intermediate Unit*

Please indicate the job-alike group with which you participate*

Job Title*

Email Address* (A valid IU email address is required in order to complete conference registration)

Phone Number*

Cell Phone Number

*** IU 21 will be offering Act 48 credit for participation in the 2017 PAIU Conference. If you are interested in receiving Act 48 credit, please enter and confirm your PPID ***


Confirm PPID

Registration Options*

Do you need any special accommodations?

An invoice will be sent by regular mail after submission of this registration form.

A registered conference attendee may, upon written request, receive a full refund of a paid registration fee as long as the request is received by the PAIU office by May 19, 2017.