Conference Information

Full Name:

How many are you registering? *

One - $95

Two - $190

Three - $285

Four - $380

Five - $475

Six - $570

Seven - $665

Eight - $760

Nine - $855

Ten - $950

Address (include city, state & zip) *

Phone *

Are you a first time attendee? *

Yes

No

Would you like to do the following?

Run for Board Position

Volunteer where help is needed

Mentor a new member or attendee

Chair a Committee

Assist with Fundraising

Name of School or Business Affiliation *

Email *

Check here to receive email updates

Comments/Questions:

ADTSEA $50 Dues *

Yes, include my $50 renewal fee

No, do not include my $50 fee

I am a new member - include $50 fee

Full Name: *

Will you need extra Banquet tickets?

1 Banquet Ticket $ 35

2 Banquet Tickets $ 70

3 Banquet Tickets $105

4 Banquet Tickets $ 140

5 Banquet Tickets $ 175

6 Banquet Tickets $210

Conference Registration