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CONVENTION REGISTRATION
Wisconsin PTA Covention Registration:
1.
Region:
2.
Unit Name:
3.
Membership Total (as of February 1st):
4.

Voting Delegates (One for every 25 members or greater portion thereof, plus 1 for the President -Article XV: Section 3):
5.
*

Name:
6.
Name (as to appear on name tag):
7.
* Address:
8.
* City, State & Zip:
9.

Please Check here if you are (Check all that apply):

 (0 required)
Attending for the 1st time WI PTA Honorary Life Member
Non-PTA Member Voting
Non-Voiting LEADer
LEADers II

 

REGISTRATION FEES  (Does not include meals):
    
***Payment MUST be sent in to the State Office & all registrations must be recieved before April 11 after that all registration will be on site.

 
10.
Member before March 31 (0 required)
2 Day $90.00 1 Day $75.00 Fri or Sat
Student $30.00
11.
Member after March 31 (0 required)
2 Day $125.00 1 Day $75.00 Fri or Sat
Student $30.00
12.
Non-Member (0 required)
2 Day $140.00 1 Day $100.00 Fri or Sat
Student $40.00
13.
Exposition Only: (0 required)
Members: $15.00 each or 2 for $25.00 Non-Members: $20.00 each or 2 for $30.00
14.
Walk for Healthy Kids: (0 required)
$15.00 Includes T-Shirt (Select size below)
15.
Shirt Size: (0 required)
Small Medium
Large X-Large
XX-Large ($2.00 extra) XXX-Large ($2.00 extra)

 

MEAL SELECTIONS:

 
16.
I will be attending the following meals: (0 required)
Friday Lunch $13.00 (Includes NORMAL performance) Exhibitor Showcase (Included with registration)
Reflections Lunch $10.00 (Winners & Parents receive 1st availability) Final Banquet $35.00

 

Please check meal choices for the above selections.
17.
Friday Lunch: (0 required)
Ham Wrap Turkey Wrap
18.
Reflections Luncheon-Build your own Sandwich, Family Style (Check the applicable box): (0 required)
Winner Parent
Delegate
19.
Final Banquet: (0 required)
Roast Sirloin Broiled Snapper
Door County Chicken

 

WORKSHOP SELECTIONS   (Please indicate workshop number only):

 
Session 1 (Friday)
20.
1st Choice
21.
2nd Choice
22.
3rd Choice

 

Session 2  (Friday)
23.
1st Choice
24.
2nd Choice
25.
3rd Choice

 

Session 3  (Saturday)
26.
1st Choice
27.
2nd Choice
28.
3rd Choice

 

Session 4  (Saturday)
29.
1st Choice
30.
2nd Choice
31.
3rd Choice

 

EMERGENCY CONTACT INFORMATION:

 
32.
*

Emergency Contact Name:  
33.
* Emergency Daytime Phone:
34.
* Emergency Evening Phone:
35.
Please list if you have any special medical concerns or allergies:

 

Checks or Money Orders are to be made payable and mailed to Wisconsin PTA, 4797 Hayes Rd. Suite 102, Madison WI 53704-3256.

REGISTRATIONS ARE NOT REFUNDABLE.

 
  
 
Call Us at 608-244-1455 or email us at wi_office@pta.org
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