Registration Page

* Indicates Required Fields.

Anna Flores, IMP/International Meeting Planers, Inc., is the conference registration coordinator and has the authority to receive funds on behalf of Region 16 ESC. For REGISTRATION FEES AND ADDITIONAL INFORMATION, please see downloadable flyer.

Make checks payable to IMP/International Meeting Planners, Inc. and mail to:
P.O. Box 10307, Corpus Christi, TX 78460-0307

For Additional Information: Phone (361) 241-4535; FAX (361) 241-7913
Email: implanners@sbcglobal.net

First Name:
*
Middle Initial:
Last Name:
*
Address:
*
Address cont.:
City:
*
State:
*
Zip Code:
*
Email Address:
* (ex. myemail@domain.com) 
Phone:
* (ex. 123-456-7890) 
Fax:
(ex. 123-456-7890) 
* Please select type:
Administrator
ESC Staff
Title I Coordinator
Teacher
Parent
Counselor
Parent Liaison
Paraprofessional/Support Staff
Other
District/Organization:
*
Campus:
*
ESC No.:
Person Submitting:
* Name of person submitting this form if different from above 
Phone:
* (ex. 123-456-7890) 
Email:
* (ex. myemail@domain.com)