REGISTRATION FORM

2011 FALL CONFERENCE - WORKSHOP PROPOSAL FORM

Creative Learning in the 21st Century

Massachusetts Art Education Association

Friday, November 11 - Sunday, November 13, 2011

Resort & Conference Center at Hyannis (formerly the Sheraton Hotel)

PLEASE INCLUDE CO-PRESENTER CONTACT INFORMATION

NO LATE REGISTRATION WILL BE ACCEPTED

Please type in the required fields below then click on "submit form"

A confirmation page will be displayed to you to ensure that your registration form has been sent. PLEASE PRINT A COPY FOR YOUR RECORDS.

Name:

Mailing Address:

City/Town:

Zip Code:

Day Telephone:

Cell Phone:

Home Telephone:

NAEA/MEA ID (if a member):

Email:

Title of Presentation:

Appropriate Grade Level(s):

Elem. Middle High All

Description of Presentation:(Use 30 words or less so it can be printed in the Conference Registration Packet that will be mailed to members.)

Limit Number of Participants: (Minimum of 24)

$ Total Supply Budget Request:(Please be realistic in your request. – Max. = $50.) Copying/handouts and Consumables only will be reimbursed (no equipment or non-consumables).

Time Needed:
Saturday:60 Min. Saturday:90 Min Sunday:120 Min.
Will you repeat the session during a second time slot: Yes No

Name:
Mailing Address:
City/Town:
Zip Code:
Day Telephone:
Cell Phone:
Home Telephone:
NAEA/MEA ID (if a member):
Email:
Title of Presentation: