NCATA Mail In Registration 2016

NCATA34thAnnualConferenceMail-InRegistration
Youmayalsoregisteronlineatwww.teacherassistants.org.
PLEASEPRINTCLEARLYWHENCOMPLETINGTHISFORM!
Step1RegistrantInformation
FirstName
LastName
FullNameasyou’dlikeittoappearonyourNameBadge
Address
SchoolName
Email(requiredtoreceiveconfirmation)
Homephone
City/State
Zip
SchoolSystem
District
CellPhone
Pleasecheckone:________NCATAMember________Non-Member
Step2ConferenceRegistrationFees
RegistrationOptions
Postmarkedonor
before2/29/16
Postmarkedonor
after3/1/16
NCATAMemberor
AssociateMember
$150.00
$160.00
$
Non-member
$200.00
$210.00
$
Amount
Step3AdditionalFees
RegistrationOptions
Postmarkedonor
before2/29/16
GuestsforSaturday
(May9)Banquet
$50.00/person
QUANTITY_____________
Name(s)/TitleforGuestBadge:
Postmarkedonor
after3/1/16
$60.00/person
Amount
$
Step4TotalFeesOwed
EnterthetotalamountowedfromSteps2and3:
$
RegistrationwillCLOSEonApril1,2016at7PM,noexceptions.
NOMOREregistrationswillbeacceptedafterApril1,2016!
Step5PaymentInformation
FULLPAYMENTbycheckormoneyorderMUSTaccompanyyourregistrationform.
ThereareNOrefunds!
Pleaseselectone:
_________Check/Moneyorderenclosed
_________*School/SchoolSystempayswithcheck/moneyorder
*IMPORTANT:GiveyourregistrationFORMtothepersonsendinginthegroupregistrationand
payment.DONOTsendtheformalone.Wecannotguaranteeyourregistrationuntilwereceive
yourpayment.
Step6ProfessionalDevelopmentPathways
Thisyearparticipantswillchooseone(1)professionaldevelopmentpathwayeachdayandattend
allworkshopswithinthatpath.Descriptionsareintheconferencenewsletter.
PleaseselectonepathwayforFriday:
________S.T.E.M.(Science,Technology,Engineering,Mathematics)
________BehavioralChallenges
PleaseselectonepathwayforSaturday:
_______TheArts:The“A”inS.T.E.A.M.
_______TheExceptionalChild
Step7AdditionalInformation
_______Iamwillingtoserveasaconferencefacilitatorforone ormoreofmyworkshops.
_______ThisismyFIRSTTIMEattendingtheNCATAAnnualConference.
_______Irequireaspecialbanquetmeal:Vegetarian______,Gluten-Free_______,Lactose-Free_______,
Diabetic_______.(Wewillworkwiththehotelcheftoaccommodateyourdietaryrequirements.)
_______Ihaveadisability&mayrequireaccommodationsto participate.(Pleaseattachdescriptionof
yoursituationand theaccommodationsyoumayrequire.Ifyourrequestis relatedtohotel
arrangements,pleasecontactthehotel directly.)
Step8SendinyourRegistrationwithPayment
Registrantswillreceiveconfirmation/receiptofregistrationviae-mailfromNCATA,so
pleaseincludeavalidemailaddresswithyourmailedregistration.CallNCATAat800979-2077ifyoudonotreceiveanemailconfirmationinatimelymanner.Allowtwo
weeksminimumforprocessingmail-inregistrations.Pleasemakechecksoutto
NCATAandwrite“ConferenceRegistration”inthe“for”line.
Refunds,Cancellations,andSubstitutions
NOREFUNDSAREGRANTED!Substitutionsareallowedusingthefollowingguidelines:Thesubstituting
attendeemustprovidealetterfromthepersonwhoseplacetheyaretakingauthorizingthesubstitution.
Thelettermustbeonschoolletterhead,signedbybothparties,datedandwitnessedbyaschool
administrator.Thesubstitutingattendeeshouldpaytheoriginalattendeedirectly,sincepaymentwillhave
alreadybeenmadetoNCATA.
ConfirmationandBadgePickup
Registrantswillreceiveconfirmation/receiptofregistrationviae-mailfromNCATA.Badgeandregistration
materialswillbepickedupuponarrivalattheconference.AphotoIDmustbeshown.Youmayonlypickup
yourpacket.
HotelAccommodations
Location:
HiltonNorthRaleighMidtown
3415WakeForestRoad
Raleigh,NC27609
Hotel Phone: 919-719-4929
Room Rate:
$135 Plus Tax Per Night – Single to Quad Occupancy
Spacious guest rooms include either one king, one queen, or two double beds. All rooms feature the Hilton Bed, coffee maker,
complimentary WiFi access, continental breakfast, and free on-site parking. All guest rooms are 100% non-smoking. The
rooms do not have refrigerators or microwaves. Check in is at 3 PM and check out is 11 AM. Complimentary shuttle is
available to and from the North Hills Shopping area. You can register for your room online by clicking HERE. The online
code is NATA.
MAILINGADDRESS
Pleasedoublecheckthatyouaremailingthisformtoournewaddress:
NCATA
POBox334
Welcome,NC27374
Thankyouforregisteringforthe2016NCATA
34thAnnualConference!Welookforwardto
rockin’withyouinRaleigh!
Letthegoodtimesroll!