IAEA CONFERENCE REGISTRATION FORM ARTISTIC FUSION NOVEMBER 4-6, 2010 LISLE, IL

Use this form for MAIL-IN registrations only. Please make a copy of all forms and payments before mailing. Print your registration screen and payment screen before exiting online
registration. You will NOT receive a confirmation receipt from Pay Pal or your credit card company. You can only use a credit card or Pay Pal if you are registering online.
PLEASE PRINT OR TYPE:

Conference Pre-Registration Fees NOTE: If registering as a student member or a student non-member

Select one fee category:
■ Member - $185
■ Retiree Member - $110
■ Student Member - $95*
■ Non-Member - $230
■ Retiree Non-Member - $130
■ Student Non-Member - $105
ONLINE, you must send proof of your student status with your fall class Payment
schedule indicating you are a full-time student by email to Kimberly Butts
at: kimberly.butts@gmail.com . Undergraduate students need at least
12 credit hours and graduate students qualify with 9 or more credit hours
and must not be employed in a teaching position. If you are mailing your $ _______________
registration and payment, include a copy of your fall class schedule.

Membership Fee (if renewal or new member payment is due for the 2010–2011 membership year) $ _______________
Please complete online membership process OR include membership form if mailing materials. If you have already renewed, we recommend that you include a
copy of your payment check and membership form. Form is available on the IAEA website (online version and downloadable version for mailing.) Keep copies for
your records. To receive the IAEA membership PRE-REGISTRATION DISCOUNT RATES, you must renew or join IAEA by the October 12 registration deadline.

Off-Site Pre-Ticketed Workshops and Tours $ _______________

Enter total from the Pre-Registered Tour and Workshops form. ALL TOURS AND WORKSHOPS AND SOME SESSIONS
for 2010 are PRE-REGISTERED. Refer to the Tours and Workshops Form for an itemized list of offerings.

Additional Guest Reservations

Please include the names of your guests. Remember, your paid registration includes all of your meal functions.
Guests Names: ___________________________________________________
Friday Luncheon
12:00-2:00 pm ________________________________________________________________ $30 x number of guests $ _______________
________________________________________________________________

Guests Names: ___________________________________________________

President’s Reception
Friday ________________________________________________________________ $30 x number of guests $ _______________
5:30-7:15 pm
________________________________________________________________

Guests Names: ___________________________________________________

Saturday Luncheon
12:00-2:00 pm ________________________________________________________________ $30 x number of guests $ _______________
________________________________________________________________

Total Payment FOR CONFERENCE REGISTRATION, TOURS, PAID WORKSHOPS, AND GUEST MEALS $ _______________
GRAND TOTAL
Name ____________________________________________________________________________
Pre-Registration Cut-Off is
Address __________________________________________________________________________
OCTOBER 12, 2010
City ______________________________________ State___________ Zip+4 __________________
NO EXCEPTIONS
Home Phone ________________________________Work Phone ____________________________ After October 12th, please register on-site at the conference.
All on-site registration categories will include
Cell ______________________________________________________________________________ an additional $30.00 charge.
Email ____________________________________________________________________________
(for mail-in registrations only, you will receive an email confirmation of your registration
and payment after these are processed) CONFERENCE NAMETAG INFORMATION
Teaching Level Council Name:____________________________________________________________
■ Elementary ■ Northeast
■ Middle School ■ Northwest
School Name:______________________________________________________
■ Secondary ■ Central
■ Higher Ed ■ South Teaching Level: ____________________________________________________
■ Admin/Sup
■ Museum Ed Other Information
If sending this form by mail, Please make check payable to IAEA.
■ Retired ■ I’m a new member (NO PURCHASE ORDERS OR CREDIT CARD PAYMENTS ACCEPTED)
■ Student ■ This is my first IAEA Conference
■ Friend of IAEA Send form and payment to: Kimberly Butts
514 Porten Road
■ Please check here if you are a full-time student and have contacted Anne Becker
Island Lake, Illinois 60042
about applying to be a Student Assistant. Refunds for the discounted registration
amount will be sent to you after the conference pending confirmation of your service
hours. Dr. Becker can be contacted at abecker@colum.edu with questions. Any questions or issues with mail-in registration, please contact:
Kimberly Butts (847/340-3396) or via email at:
To join or renew your IAEA membership for the 2010-2011 membership year, go to the kimberly.butts@gmail.com
IAEA website (www.ilaea.org) and register online OR download the PDF file. The 2010
IAEA summer Mosaic issue with conference information can also be accessed from the Any questions or issues with online registration, please contact:
IAEA website. Chris Doebler at: cmdoebler@yahoo.com

REFUND POLICY: Conference registration refund requests must be submitted in writing and include your confirmation sheet. If you submit your request by October 12,
you will receive a refund minus a $35.00 processing charge. Refund requests will not be accepted after October 12. To have someone attend the conference and/or a
workshop in your place, you must submit an authorization letter and copy of your registration confirmation to Kimberly Butts by October 25. Workshop registrations will NOT
be refunded unless the workshop is cancelled by the presenter or IAEA, or the session has filled by the time we receive your form and payment. Allow 4-6 weeks after the
conference to receive your refund.
IAEA PRE-REGISTERED WORKSHOPS AND SESSIONS FORM PAGE 1 OF 2
Please make a copy of all forms and payments submitted for your records. Deadline to pre-register and pay for all tours, workshops and special events is
October 12. After October 12, you may register on-site for any open workshops, tours and special events.

You may print this form and submit it with your payment to Kimberly Butts (address is listed on page two of this form) OR you may complete it online and
include payment through PayPal or your credit card company. You MUST print out your online registration and payment transactions before leaving the
screen as you will NOT receive confirmation from PayPal or your credit card company.

Please refer to the summer IAEA Mosaic issue (on the IAEA website) which contains descriptions, dates, times and other information about items listed on
this form.

REGISTER TODAY - SESSIONS AND WORKSHOPS ARE LIMITED AND WILL FILL QUICKLY

PRE-REGISTRATION DEADLINE IS OCTOBER 12, 2010 (POSTMARK DEADLINE AND ONLINE REGISTRATION DEADLINE)

On-Site Pre-Ticketed Workshops and Sessions..............................................................COST............LIMIT ..................PAYMENT

Fri 10:00 - 11:45 am ........Millefiori Art with Polymer Clay ..........................................................................$20.00................15 ..................$ ____________
Fri 10:00 - 11:45 am ........Kinetic Sculptures ..............................................................................................$5.00 ................15 ..................$ ____________
Fri 10:00 - 11:45 am ........Websites, Wikis, Blogs, etc ..................................................................................NC .................. 20 ............................ ■
Fri 10:00 - 11:45 am ........A Master Approach to Paper Mache ....................................................................NC ..................20 ............................ ■
Fri 11:00 - 11:45 am ........How to Draw Anything ..........................................................................................NC ..................24 ............................ ■
Fri 2:15 - 4:00 pm ..........Self Portraits with Color Pencils ........................................................................$5.00 ................20 .................. $ ____________
Fri 2:15 - 4:00 pm ..........The Art of Papel Picado ......................................................................................NC ..................20 ............................ ■
Fri 2:15 - 4:00 pm ..........Tunnel Book Creation ..........................................................................................NC ..................20 ............................ ■
Fri 2:15 - 4:00 pm ..........Peyote Tube Beads ............................................................................................$5.00 ................15 ..................$ ____________
Fri 2:15 - 4:00 pm ..........I’m Through, What Do I Do?..............................................................................$20.00................20 .................. $ ____________
Fri 3:15 - 5:00 pm ..........Planning a Community ........................................................................................NC ..................20 ............................ ■
Fri 4:15 - 5:00 pm ..........Altered Perspective - Your Place in Space…….. ................................................NC ..................24 ............................ ■
Fri 4:15 - 5:00 pm ..........All Stirred Up ........................................................................................................NC ..................20 ............................ ■
Fri 4:15 - 5:00 pm ..........Relativity for Kids .................................................................................................NC ..................24 ............................ ■
Fri 4:15 - 5:00 pm ..........Tapestry Design (MAYCO) ..................................................................................NC ..................20 ............................ ■
Fri 4:15 - 5:00 pm ..........Special Education Lessons ..................................................................................NC ..................25 ............................ ■
Fri 7:30 - 9:00 pm ..........Fun and Whimsical Clay (Amaco/Brent) ..............................................................NC ..................20 ............................ ■
Fri 7:30 - 9:00 pm ..........Altered Penny Carpet (Blick Art Materials) ..........................................................NC ..................20 ............................ ■
Fri 7:30 - 9:00 pm ..........Fuzzy Flowers and Crystal Flowers (MAYCO ......................................................NC ..................20 ............................ ■
Fri 7:30 - 9:00 pm ..........Got Clay? Hand-Building (Ceramic Supply)........................................................NC ..................15 ............................ ■
Fri 7:30 - 9:00 pm ..........Wonderfully Wooly (Esther’s Place) ....................................................................NC ..................15 ............................ ■
Fri 7:30 - 9:00 pm ..........3-D Dragon Masks (Nancy Staszak) ..................................................................NC ..................20 ............................ ■
Sat 9:00 - 9:45 am ..........Toys, Patterns and Paradise – MFA Quest ..........................................................NC ..................24 ............................ ■
Sat 9:00 - 10:45 am ..........Figurative Clay Whistles .....................................................................................$5.00 ................20 ..................$ ____________
Sat 9:00 - 10:45 am ..........Deaf Artists in America .........................................................................................NC ..................24 ............................ ■
Sat 9:00 - 10:45 am ..........Paper Coil Baskets (Blick Art Materials) .............................................................NC ..................20 ............................ ■
Sat 10:00 - 10:45 am ........Giacometti in Motion ............................................................................................NC ..................20 ............................ ■
Sat 2:15 - 3:00 pm ..........Silver Point Drawing ............................................................................................NC ..................20 ............................ ■
Sat 2:15 - 3:00 pm ..........Getting into the Zone ...........................................................................................NC ..................18 ............................ ■
Sat 2:15 - 4:00 pm ..........Altered Books ....................................................................................................$5.00 ................20 ..................$ ____________
Sat 2:15 - 4:00 pm ..........Recycled Art: Papermaking and Jewelry..............................................................NC ..................20 ............................ ■
Sat 3:15 - 4:00 pm ..........Yi-Xing Style Teapots............................................................................................NC ..................20 ............................ ■
Sat 3:15 - 4:00 pm ..........Art Stamps.............................................................................................................NC ..................24 ............................ ■
Sat 3:15 - 5:00 pm ..........Exploring Aboriginal Art.........................................................................................NC ..................24 ............................ ■
Sat 4:15 - 5:00 pm ..........Engaging Non-Art Education Majors ....................................................................NC ..................24 ............................ ■
Sat 4:15 - 5:00 pm ..........What my Students Taught Me ..............................................................................NC ..................24 ............................ ■
Sat 4:15 - 5:00 pm ..........Taiwanese Eating Culture ....................................................................................NC ..................24 ............................ ■
Sat 4:15 - 5:00 pm ..........Architecture Unit Frank Lloyd Wright....................................................................NC ..................24 ............................ ■

SUBTOTAL (please carry this total cost of on-site pre-ticketed workshops and sessions to other side) ......................$ ____________

NOTE: YOU MUST CHECK THE BOX TO RESERVE YOUR PLACE IN THE WORKSHOPS WITH NO FEES BOTH ON- AND OFF-SITE.
IAEA PRE-REGISTERED WORKSHOPS AND SESSIONS FORM PAGE 2 OF 2
Please make a copy of all forms and payments submitted for your records. Deadline to pre-register and pay for all tours, workshops and special events is
October 12. After October 12, you may register on-site for any open workshops, tours and special events.

You may print this form and submit it with your payment to Kimberly Butts (address is listed below) OR you may complete it online and include payment through
PayPal or your credit card company. You MUST print out your online registration and payment transactions before leaving the screen as you will NOT receive
confirmation from PayPal or your credit card company.

Please refer to the summer IAEA Mosaic issue (on the IAEA website) which contains descriptions, dates, times and other information about items listed on this form.

REGISTER TODAY - SESSIONS AND WORKSHOPS ARE LIMITED AND WILL FILL QUICKLY
Make sure you have not signed up for two sessions that meet at the same time – check the conference schedule in the Mosaic before making your selections.
Mailing workshop and session choices does not guarantee a place in these presentations. We will notify you of any workshops you paid for that have closed,
and you will receive a refund after the conference. Please check with the registration area at the conference to see if any closed sessions have opened up or if
there are any changes in the program schedule since the Mosaic and registration forms were published.

PRE-REGISTRATION DEADLINE IS OCTOBER 12, 2010 (POSTMARK DEADLINE AND ONLINE REGISTRATION DEADLINE)

Off-Site Pre-Ticketed Workshops and Tours ....................................................................COST............LIMIT.................. PAYMENT

Fri 2:30 - 4:30 pm ..........Arboretum Tour – Tour of the Rare Print Collection..........................................$10.00................20 .................. $ ____________
Fri 2:30 - 4:30 pm ..........Arboretum Workshop – Color Pencils Tricks ....................................................$20.00................20 .................. $ ____________
Fri 3:30 - 5:30 pm ..........Ed Hoy Studio - Beginning Glass Fusing..........................................................$10.00................20 .................. $ ____________
Sat 8:30 - 10:30 am ..........Arboretum Workshop – Drawing Little Jewels ..................................................$20.00................20 .................. $ ____________
Sat 8:30 - 10:30 am ..........Arboretum Workshop – Learning Watercolor....................................................$20.00................20 .................. $ ____________
Sat 8:30 - 10:30 am ..........Arboretum Workshop – Nature Journaling ......................................................$20.00................15 .................. $ ____________
Sat 8:30 - 10:30 am ..........Ed Hoy Studio– Mosaics and Beyond ..............................................................$10.00................20 .................. $ ____________
Sat 2:30 - 4:30 pm ..........Arboretum Workshop – Using Graphite in Illustration ......................................$20.00................20 .................. $ ____________
Sat 2:30 - 4:30 pm ..........Arboretum Workshop – Working with Pen and Ink ..........................................$20.00................20 .................. $ ____________
Sat 2:30 - 4:30 pm ..........Arboretum Workshop – Learning Watercolor....................................................$20.00................20 .................. $ ____________
Sat 2:30 - 4:30 pm ..........Blick Art Store – Art Demos and Reception ........................................................NC ..................30 ............................ ■
Sat 2:30 - 4:30 pm ..........Raku Firing Demonstration - All Fired Up About Clay ............................................NC ..................20 ............................ ■

Total Off-Site Pre-Ticketed Workshops and Tours ................................................enter total from above ........................$ ______________

Total On-Site Pre-Ticketed Workshops and Sessions ............................enter total from page one of this form ............$ ______________

TOTAL PAYMENT FOR TOURS, WORKSHOPS AND SESSIONS $ ______________

(both on and offsite - pages 1 and 2 of this form) Transfer this total amount to the Conference Registration Form WORKSHOP TOTAL

NOTE: YOU MUST CHECK THE BOX TO RESERVE YOUR PLACE IN THE WORKSHOPS WITH NO FEES BOTH ON- AND OFF-SITE.

To register and pay online, follow instructions listed on the Registration Form and in the summer Mosaic issue.
• If you are paying for Tours and Workshops and Additional Tickets with your conference registration, you must transfer the total payment
listed above to the Conference Registration Form on the appropriate line.
• If you are mailing your conference registration, make all checks payable to: IAEA
• Remember that IAEA does not accept purchase orders, and you cannot use a credit card with mailed registration. We
cannot hold workshops until payment and forms are received.
• Before mailing, make a copy for your records and send the form and payment to: Kimberly Butts
514 Porten Road
Island Lake, Illinois 60042

PRE-REGISTRATION DEADLINE IS OCTOBER 12, 2010 (POSTMARK DEADLINE AND ONLINE REGISTRATION DEADLINE)

• Check with the Registration Area at the conference to see if there are any openings for workshops, tours, special events and any
pre-registered sessions.
• Reminder – SOME SESSIONS are held in workshop rooms and must be PRE-REGISTERED on this form. ALL WORKSHOPS are
PRE-REGISTERED (both on-site and off-site).
• Check the Mosaic for more detailed descriptions of the presentations. Not all workshops have a participation / supplies fee. Note some
technology sessions recommend or require that you provide your own equipment.
• You will be notified prior to the conference if you pre-registered and there are materials you need to bring.