PRE-REGISTRATION FORM AMEA In-Service Conference


January 10-12, 2008University of Alabama, Tuscaloosa, Alabama


LAST NAME ______________________________ FIRST NAME______________________(for badge)


MENC ID#_________________________________ Please enclose a copy of your card.


Home Address: __________________________________ ____________________ ______ _______ (City)


(State) (Zip)


Home Phone: ______________________________ Email: __________________________________ School Name: ______________________________________________________________________


School Address: _________________________________ ____________________ ______ _______ (City)


(State) _____AVA _____ELEM _____AOA (Zip)


School Phone: ______________________________ Fax: ___________________________________ Division Affiliation: (check all that apply) _____ABA


_____HED _____CMENC


Please tell us if you are: _____Clinician _____Conductor of a performing group at the conference _____Retired


_____Guest Performer


Current Members, Clinicians, Conductors


Pre-Registration $70.00 (On-Site Registration $80)


Retired Members Registration Complimentary First Year Teachers


Pre-registration $55.00 (On-Site Registration $65)


CMENC Members


Pre-Registration $20.00 (On-Site Registration $25)


Spouse* or Guest* of AMEA Member Registration $15.00


Name for Badge: ____________________________________ *may not be a music teacher


TOTAL AMOUNT PAID $____________ MAKE CHECKS PAYABLE TO AMEA A fee of $35 will be charged for returned checks


No Purchase Orders Accepted. Check or Credit Card Only To pre-register with a credit card go to www.alabamamea.org through January 1, 2008


************************* Mail form and check by Jan. 1, 2008 to: *********************** AMEA, Box 181, 1612 Second Avenue SW, Cullman, AL 35055


Important: Forms and payment received after Jan. 1, 2008 will be held at the registration desk for onsite registration. Do not send forms or payment to the above address after Jan. 1, 2008


THANK YOU! Your conference packet will be ready at the registration desk in the Bryant Conference Center. Your receipt will be in your packet at the conference. Please contact me if you need further assistance. Cindy Pass, Treasurer, AMEA and Registrar Phone: (256) 338-4404 email: cpass@cullmancats.net


************************************************************************************************************************************** Please do not fill in the information below. This is for AMEA bookkeeping ONLY


Personal Check # _________________________ ala breve School Check # ______________________ Membership verified and payment receipted by: ________________________________ Date: ____________________ 21


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60