Credit Card. Credit Card # ... Payments: Email:
; Fax: 512.852.4552 (Credit Cards/POs Only) OR. M
Houston | Nov. 29 - Dec. 1
Connecting Minds. Empowering Futures.
Registration Form
STEP 1: CONTACT INFORMATION (1 person per form) Name Email School/District/Company Region (1-20) Address Home Work City/State/Zip Phone Role: Coordinator ( District / Campus Level) Classroom Teacher Consultant G/T Specialist Position Title How long have you been in this role? Less than a year
District Type: Rural
2-4 years
4-7 years
Urban
Other: Suburban
More than 7 years
How many times have you attended the Annual Conference? First Time 2-3 times 4-5 times More than 5 Are you interested in TAGT volunteer opportunities? Yes
STEP 2: REGISTRATION EARLY (July 1 - Oct. 11) Member*/Non-Member
REGULAR (Oct. 12 - Nov. 15) Member*/Non-Member
LATE (After Nov. 15 and Onsite) Member*/Non-Member
Three Day
$415 / $500
$465 / $550
$490 / $575
Wednesday
Two Day
$300 / $385
$350 / $435
$375 / $460
Thursday
One Day
$155 / $240
$205 / $290
$230 / $315
Friday
Professional Membership Dues *
Day(s) Attending
$65
Professional membership must be current through 2017 for discounts to apply. For membership status call 512.499.8248.
STEP 3: PAYMENT Total amount to be paid: $ Payment Method: Check #
PO # (no requisitions) Credit Card
Credit Card # Expiration Date CVV Business Cardholder Name (if applicable) Signature Billing Address Same as above Payments: Email:
[email protected]; Fax: 512.852.4552 (Credit Cards/POs Only) OR Mail: TAGT Annual Conference, PO Box 1918, San Antonio, TX 78297 Cancellations: Refund requests must be in writing by November 15, 2017. An $80.00 processing fee will apply for each cancellation. Memberships are nonrefundable.
ADDITIONAL INFORMATION • Questions? Call Justin Ables, Member Services Manager, at 512.499.8248 • Registration confirmations are sent electronically. Be sure the email address provided is able to receive emails from TAGT. • TAGT photographs events and reserves the right to use the photos for promotional purposes. • Group and student registration discounts are also available at tagtconference.org.
