NJMEA Music Conference Pre-Registration Form A list of those who are registered for the conference will be posted weekly at
njmea.org
February 21-23, 2013 * One form per registrant * Pre-registration deadline: February 8, 2013 IMPORTANT: Registrations Post Marked After February 8, 2013 WILL BE RETURNED TO THE SENDER Be Sure To Read The “Procedure For Registration” BEFORE Completing This Form
Name Address
Email Address: Home Phone #:
City: School District Name:
Are you an NAfME member? NAfME members must attach a copy of their NAfME Card showing ID # and Expiration Date. q Yes (Must be Feb 2013 or later) q No (If NAfME membership expires prior to March 2013, you must renew before registering).
CONFERENCE REGISTRATION FEES
ONLY CREDIT CARDS OR CHECKS, MADE PAYABLE TO NJMEA WILL BE ACCEPTED. PURCHASE ORDERS RECEIVED AND ACCOMPANIED BY A COPY OF THIS FORM WILL BE SIGNED AND RETURNED FOR PAYMENT.
PURCHASE ORDER PAYMENT MUST BE MADE BY APRIL 2, 2013. * * * * Send All Checks & Purchase Orders To: * * * *
Kathy Mosher, 80 Jumping Brook Drive, Lakewood, NJ 08701 (DO NOT SEND SIGNATURE REQUIRED)
Questions:
kathleen.mosher1@
gmail.com or 732-367-7194
THE FULL CONFERENCE INCLUDES ONE ACADEMY BEING OFFERED ON THURSDAY AT NO ADDITIONAL CHARGE; ALL OF FRIDAY AND SATURDAY; PLUS ONE (1) CONCERT TICKET
PLEASE CHECK ONE (1) ACADEMY FROM THE LIST BELOW THE CONFERENCE REGISTRATION (Please note: lunch will be on your own on Thursday)
Category (PLEASE CHECK ONLY ONE) ❑Full Conference ❑Family Member (FM Requires separate form) ❑ Full Conference - Retired NAfME Member (Does not include concert ticket)
❑ Full Conference - Retired NAfME Member Spouse (RMS Requires separate form) (No CT) ❑Full Conference - Non-Member - (Does not include NAfME Membership)
Pre-Register On-Site $150.00 $150.00 $30.00 $30.00
$270.00 ❑Full Conference - Collegiate NAfME Member (Includes Collegiate Academy & Lunch on Saturday) $50.00
(Does not include concert ticket) PLEASE CHECK THE ACADEMY YOU WISH TO ATTEND ON THURSDAY (NO CHARGE)
❑ Choral Academy ❑ Jazz & Marching Band Academy
❑ Wind Band Academy ❑ Elementary Academy
❑ Luncheon Ticket (Required to Attend Ballroom Friday Lunch) ❑ One Extra Concert Ticket (This is for those not receiving a concert ticket with registration TOTAL ❑ I will attend Friday Concert (King’s Singers) TEMPO ❑ I will not attend Friday Evening Concert
Friday Evening Concert: (1 concert ticket is included with all Friday/Saturday conference registrations of $150 or more if checked above) Concert tickets are NOT included with collegiate and retired member registrations.
Tickets will be issued to the first 750 requests. If the “will attend” box is unchecked, no ticket will be provided. Additional tickets may be purchased at the registration desk on Friday at $25.00 each.
46 JANUARY 2013
❑ Technology Academy ❑ NONE
$35.00 $____________ $25.00 $____________
$____________
$160.00 $160.00 $40.00 $40.00
$280.00 $60.00
You may attend academies other than the one you check, but we need to know the main selections IF YOU ARE NOT ATTENDING AN ACADEMY ON THURSDAY, PLEASE CHECK “NONE”
Amount Due ____________ ____________ ____________ ____________ ____________ ____________
Name for Badge State:
First Name or Nickname ONLY (One Word) Zip:
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