PRE-REGISTRATION FORM


AMEA In-Service Conference January 17-19, 2019


Birmingham-Jefferson Convention Complex Home Address: (City) Email:


Primary Phone: School Name:


Principal Division:(check only one) ABA


AVA AVA ELEM


Other Division/s Affiliation:(check all that apply) ABA


ELEM


Please tell us if you are: Clinician


Current Member, Clinician, Conductor


AOA AOA HED HED


Conductor of a performing group at the conference First Year Teacher


Pre-Registration $95.00 (On-Site Registration $110.00)


Retired Member Registration Complimentary TOTAL AMOUNT PAID $


Pre-registration $75.00 (On-Site Registration $85.00)


Spouse* or Guest* of AMEA Member


Registration $15.00 *may not be a music teacher


Name COLLEGIATE COLLEGIATE Retired


Collegiate Member (college student)


Pre-Registration $40.00 (On-Site Registration $55.00) Luncheon: Yes


No


Non-Member Alabama Music Teacher


Pre-Registration $222.00 (On-Site Registration $237.00)


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 8, 2019


Mail form and check by Jan. 8, 2019 to: AMEA Registration, PO Box 3385, Muscle Shoals, AL 35661


Important: Forms and payment received after Jan. 8 will be held at the registration desk for onsite registration. Do not send forms or payment to the above address after Jan. 8, 2019!


THANK YOU! Your conference packet will be ready at the registration desk in the Sheraton Hotel. Your receipt will be in your packet at the conference.


14 August/September 2018 (State) (Zip)


LAST NAME _____________________________ FIRST NAME_____________________ (for badge)


NAfME ID#_______________________________ Please enclose a copy of your card.


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