NEATE 2017 FALL CONFERENCE OCTOBER 20-21, 2017 REGISTRATION FORM

Name: ______Phone: ______Home Address: ______City: ______State:___ Zip: ______School: ______School Address: ______Email: ______# of NEATE conferences attended. ______# of Years as a NEATE member______Your teaching level - Elementary, Middle, High, College Registration confirmations (NEATE SpeedPass) will be emailed before the conference begins.

If you register by October 2, 2017, you can subtract an additional $15 from your conference fee. (See “Amount Due” section below). Excludes Student Special Rate. Be among the first 50 to register and receive Gish Jen’s new book free.

CONFERENCE FEES: Member / Non-member MEAL TICKETS: (circle one) (check one) Friday only $110 $140* _____ Friday Luncheon $29 Saturday only $100 $130* _____ Friday Vegetarian $29 Friday & Saturday $160 $190* Student Special $ 50*@ AMOUNT DUE: * = includes membership 10/1/17-9/30/18 Conference Fee $______*@=Full-time undergraduate and graduate students who are not employed Early Reg. (10/2/17) – 15.00 Presenter Discount £ - 25.00 MEMBERSHIP: (Circle one) Sub Total = $______1 YEAR 2 YEARS Meals + $______Regular $20 $35 Membership Fee + $______Full-time Student $10 $20 TOTAL =$______Retired Teacher $10 $20 £ = Must have accepted session proposal

Purchase Order # ______NEATE’s Tax ID #23-7025784. Your Purchase Order MUST arrive prior to the conference or you will need to pay by check or credit card. NEATE accepts Visa, MasterCard, Discover, and Diners Club. To take advantage of this benefit, please fill in the information below: ______Card Number and Type (Visa/MC/Discover, Diners Club) Expiration Date Signature https:// Hotel Information: The NEATE Conference rate for rooms at the Holiday Inn Mansfield/Foxboro Send the registration form above, along with is $118 plus tax for up to four people. The cutoff your payment or Purchase Order information, to: date is September 26, 2017. Make reservations Richard A. West, NEATE Treasurer, 843 Gould directly with the hotel at Hill Road, Contoocook, NH 03229-2816 https://tinyurl.com/y7hc4yac using code Email:[email protected] TCH. Fax: 1-888-371-3166

Cancellation Policy: Participants unable to attend may send a substitute without penalty as long as you notify registration. Full refund is available on or before 9/23/17; a $25.00 handling fee will be charged for cancellation between 9/24/17 and 10/7/17; no refund after 10/7/17, extenuating circumstances will be reviewed.