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REGISTRATION FORM <br /> AMERICAN ASSOCIATION OF SCHOOL ADMINISTRATORS ■THE NATIONAL CONFERENCE ON EDUCATION ■FEBRUARY f 0-13, 1995, NEW ORLEANS <br /> Return this form with payment to: CONFERENCE TUITION FEES <br /> r Department 79289, Baltimore, MD 21279-0289;800.771-1162. Each registration will include a nonrefundable processing fee of$70. <br /> #of people Total <br /> ISee page 17 for registration instructions. O (1) AASH member fee <br /> I Please complete all items below. Leave one open box between words. A� m <br /> 2 team members $435 x <br /> 's 34 team mebers• 3392' x 7 3%L <br /> I J 5+members- $370' x <br /> M <br /> E <br /> MBER/CUSTOMER ID#IIF APPLICABLEI -Team rates apply when at least one registrant of your team is an AASA member.All team members <br /> Ii N U R E N must register at Ne same mine,complete separate forms,and be from the same school district. <br /> IIndicate payment rotats on only one form. <br /> LAST NAME J (2) Non.AASA member fee $525 x <br /> IO (3) Comprehensive fee(includes 1 year <br /> RASA membership @$219) $654 x <br /> („� I� � � � �� � 7 J � � ❑ (4) Professed student fee E295 x <br /> I FIRST NAME INITIAL J (5) One-day fee $225 x <br /> O Friday J Saturday J Sunday J Monday <br /> ITrt� 1" ❑ (6) Complimentary(see Conference Tuition 0 <br /> �+ 5 1J EZ 1 V M lis Fee section eligibility requirements) <br /> I � 161IO (95 CC9S) Conference- S 50 x <br /> SCHOOL DISTRICF NSTITUTION Within-a-Conference <br /> 10 n �„)'!r �'� (% lA1(IV I.Pr A, L- TICKETS—NO EXCHANGES OR REFUNDS <br /> OFFICE ADDRESS _ _ _ J (Fl) Federal Relations . <br /> Luncheon $35 x <br /> CITY STATE 2tP J (T2) Minority Affairs/ <br /> S r '. ^ y O _ - Women's Caucus/ $35 x <br /> 3 Women Administrators <br /> TELEPHONE# Committee Breakfast <br /> J (T3)Parmers Program <br /> Luncheon $35 x <br /> FAX# <br /> J(96)Partner's name and home address(for complimentary registration) MEMBER DUES <br /> Regular member dues(12 mos.) $219 x <br /> Other AASA membership dues S x <br />' J(97)Children's name(s)(for complimentary registration if under 18 years old) (student,professor,retired),please see <br /> membership dues information for costs <br /> PRE-CONFERENCE PROGRAMS <br /> Registration Includes a$50 nonrefundable processing fee separate from Conference processing fee. <br /> Team rates do not apply to these programs: <br /> PUKE ADDRESS LABEL HERE. Cl (ESAS) AAESA Leadership Seminar $150 x <br /> Look on the back corer of this O (Q507) Basic Tools of Quality $450 x <br /> Conference registration pocket or on envelope. <br /> See below for team rates that apply to these programs: <br /> O (C509)Curriculum-Driven Budgets $350 x <br /> J (PS 10) Strategic Planning in the'90s $350 x <br /> O (Q508)What School Leaders Must $350 x <br /> Are you a first-time attendee? 1/ Yes 0 No Know About OBE <br /> ❑ (5512)Using"Dialogue"as Tool $195 x <br /> JOB FUNCTION DISTRICT ENROLLMENT, for Systemic Change <br /> OCheck one only. Check one only. J (5511)School Restructuring:Round Two$195 x <br /> J (00) Superintendent J A 25,000 or more J (L514) Making Schools Safe in $195 x <br /> J (01) Deputy Supt. J B 10,000-24,999 Culture of Violence <br /> J (02) Asst./Assoc.Supt J C 51000-91999 <br /> O (21) Curriculum/Instruction Dir. J D 3,000-4,999 O (C513)Curriculum Audit Overview $195 x <br /> O (28) School Board Member J b 2,000-2,999 <br /> J (29) Other Central Office Dir. 4r F 1,000-1,999 TEAM RATES FOR PRE-CONFERENCE PROGRAMS <br /> J (30) Principal J G 600-999 1-2 people 3-4 people(10%discount) S a people(15%discount) <br /> J (34) Asst.Principal Cl H 300-599 $195 ea. 5175 ea. 3166 ea. <br /> ❑ (53) University Professor J 1 300 or fewer $350 ea. 3315 ea. 5297 ea. <br /> 7 (58) Student POST-CONFERENCE PROGRAM <br /> V(89) owerB� C .rmtlFee Meru +' <br /> ❑ (1521) FSEA Reauthoritarion $ 150 x <br /> DISTRICT CLASSIFICATION <br /> J Urban J Suburban Rural GRAND TOTAL <br /> PURCHASING ROLE PAYMENT OPTIONS <br /> OWhat is your role in product/service How much of your annual budget Charge my credit card: $ (am't) <br /> purchasing for your district? do you spend on product/service J VISA <br /> Check all that apply. purchases? c im# rxe.DATE J MasterCard <br /> J A Final say J H 10% J AmEx <br /> J B Recommend J I 15% J Discover <br /> 0 J C Specify supplier J J 20% SIGNATURE DATE <br /> J D No involvement J K 25% My check is enclosed(payable to AASA in U.S.dollars) E (am't) <br /> O E Establish budget levels available J L 3096 <br /> to make purchases J M 3596 <br /> VMy purchase order# is enclosed. $ (aro's) <br /> F Determine need for product/service J N 40% GCM095. Please include this number on your purchase order or <br /> J G Select specific product/service J 0 so% check to expedite processing. <br />