Register to Attend NTA Conference

National Tutoring Association

Conference Registration Form

Early Registration Deadline: March 13, 2009
Please Print or Type As You Would Like Information to Read on Your Nametag

Last Name_____________________________________ First Name_______________________________

Institution or Affiliation
_______________________________________________________________________________________

Office Address ___________________________________________________________________________________

City _________________________________________________ State ________________ Zip ____________

Phone __________________________________ FAX ___________________________________

Email (required for registration confirmation) ___________________________________________________________________________________________

Current Position or Title _____________________________________________________________________

Please check if this is your first NTA Conference ? Vegetarian Meals

Special Needs _________________________________________________________________

CONFERENCE FEES (Does Not Include Annual Membership
)FULL CONFERENCE

Registration Fee For Members	$265.00 - Early Registration received by March 13, 2009 $325.00 - Late Registration
For Non-members	$310.00 - Early Registration received by March 13, 2009 $350.00 - Late Registration
For Undergraduate Students For Graduate Students	$175.00 - with proof of status $195.00 - with proof of status
PER DAY FEES
Registration Fee to Attend One Day	$175.00 Which day? _______________________
Undergraduate Students	$145.00 Which day? _______________________
* Full time or part-time graduate students not employed full time by the college or university.
TOTAL BASIC REGISTRATION FEES	$ _________________

ADDITIONAL WORKSHOPS:
Training Your Tutors	$145.00	Academic Coaches Part I		$75.00
Critical Thinking	$ 55.00	Learning Preferences		$145.00
Leadership Strategies	$ 65.00	Creative Funding Sources		$65.00
Negotiation Skills	$ 65.00	Employees/Contract Workers?		$55.00
Academic Coaches Part II	$ 75.00	Baking up Team Building Skills		$65.00
TOTAL ADDITIONAL WORKSHOP FEES	$_________________

TOTAL AV FEES (Presenters Only)	$ _________________
TOTAL CONFERENCE FEES ENCLOSED	$ _________________		NTA's FEIN:35-2196495

Make Checks Payable to the NTA (FEIN:35-2196495)
Send Completed Form with check or PO to:
Dr. Sandi Ayaz, Executive Director
National Tutoring Association PO Box 6840 Lakeland FL 33807-6840

All Fees Are Due Before the Conference Begins
NTA Accepts VISA, MC, AMEX and DISCOVER via fax 863-644-9621