SEPA 2014 Delegate Registration Form

Please fill out the form below to begin the registration process for the SEPA 2014 annual conference. All fields in bold are required.

Personal Information
Middle Initial
Preferred Name
Address Line 2
ZIP Code
Work Phone
Fax Number
Mobile Phone
Additional Email
Registration Specifics
Student Registrant Information
If you would like to use a credit card to pay for your conference registration and/or SEPA dues, we will email you a credit card authorization form. Once filled out, the form can be returned via email, fax, or post.
There will be a $5 administrative fee applied to all standard registrations and a $2.50 administrative fee applied to all student/part-time registrations.
Food & Lodging
Dietary Restrictions
Guest/Spouse Registration
In attendance (Please check all that apply):
Dietary Restrictions
Please contact us to separately invoice you for guest/spouse registration. By default, will we NOT include these fees on your standard invoice.
Additional Comments


Want more info? Contact us.

General Information:
Derek Demeter

School Field Trips:
Michael McConville

Media Requests
Derek Demeter

Seminole State General Contact Information