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Smoky Hill Education Service Center

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CTE Conference Registration Form

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Registration Information (Please submit a separate form for each registrant.)
First Name:

Last Name:


Mailing Address:



Zip Code:

Phone Number:

E-mail Address:

Content Area/Role: (Please select primary Career Cluster area taught if you are a classroom teacher)


Payment Information:Bill District    District P.O.    Credit Card

Attendance Options:Full Conference February 12 ONLY February 13 ONLY Presenter   Pre-Conference only (no charge)

Optional Events (Please check all that you plan to attend.)

Perkins V Training  February 11th 8:30am - Noon  no charge
New CTE Coordinators Session with Stacy Smith February 11th 2:00-3:45 pm  no charge


      FutureMaker Lab Walk in spots on Wednesday February 13th are available.  Please check at the registration table.  (limited to 20 per session)  no charge  T  Description  


Registrants paying by Credit Card will need to call 785-825-9185 to submit payment information.  SHESC does NOT accept Discover.

District P.O. Number:

Special Requests (diet considerations, physical accommodations, etc.):

Please make checks/purchase orders payable to:

Kansas Association of Education Service Agencies (KAESA)
605 East Crawford
Salina, KS 67401
Phone:  785-825-9185   Fax:  785-825-9195
KAESA Tax ID #48-1189820

Registration Cost & Cancellation Policy:
Early bird registration ending January 25, 2019 is $160.
Registrations received after January 25, 2019 will be charged $200.
Cancellations will be refunded in full if written notice of cancellation is provided by January 25, 2019
The registration fee for February 12th ONLY or February 13th ONLY is $100 if registered by January 25.  After January 25, the fee for a single day registration will be $150.

Registration fees for Presenters and Room Monitors are $80.

Additional Comments/Questions?

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