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NJASL 2016 Fall Conference Registration FormOcean Place Resort, Long Branch, New Jersey
November 17 - 19, 2016
Attendee Contact and Badge InformationName ____________________________________________________________Title ______________________________________________________________Library/Institution ___________________________________________________District _____________________________ County ________________________Work Phone ____________________________________________Home Address _____________________________________________________City ________________________________ State __________ Zip ___________Home/Cell Phone __________________________________________Preferred Email ____________________________________________________Please Check all that apply: NJASL member NJLA member NJAET member I have been a school library media specialist/librarian for 3 years or less This is my first NJASL Conference You can share my contact information with exhibitors Name of Accompanying Administrator/Teacher________________________________
Instructions
Please complete both pages, using only one form per person. Copy as needed. Register guests separately and include separate registration and meal fees.
All registrations and payments, including purchase orders, must be postmarked by November 1, 2016. Late submissions will not be accepted!
Conference Registration FeesPlease check off your registration category and indicate total registration fee
Registration Category In Advance On Site Member Full Conference $150 $180 Member One Day(Thurs/ Fri) $110 $140
Thursday Friday Member One Day Saturday $60 $90 Retired/Student Full Conference** $110 $140 Retired/Student One Day** $95 $125
Thursday Friday Retired/Student One Day Saturday $40 $70 Administrator/Teacher (must attend with a SLMS) FREE FREENon-Member Full Conference $250 $280Non-Member One Day (Thurs/Fri) $200 $230
Thursday FridayNon-Member One Day Saturday $100 $130
** This Special Rate is also available for School Librarians who have been displaced from their library or are part-time (20 hrs or less.)
Total Registration Fee: $ _________________
For RetireesThe registration fee will be waived for retirees who volunteer their services to help at the conference. Please contact Susan Titelbaum, [email protected], for volunteer information.
I would like to volunteer on: Nov. 17 Nov. 18 Nov. 19
Retirees who only plan to attend the Retiree’s Reception do not need to pay a registration fee but must pay for the Reception.
Registration Notes
Membership MUST BE renewed by November 1, 2016 in order to register at the member rate.
NJLA and NJAET members can register at the NJASL member rate.
Special event tickets are separate from registration fee. Please see page 2 to register for the events and make payments.
Attendance at this event constitutes permission for your photograph or video to be taken at the event and used for NJASL purposes.
Payment and Cancellation Information
Registration forms will not be accepted without a check or purchase order, and purchase orders will not be accepted post conference. Payments should be made out to NJASL.On site registrations are available with cash or money order only!
All registrations and purchase orders must be postmarked by November 1, 2016 for confirmation. Confirmations will be sent through November 9, 2016. Your cancelled check will be your receipt. Receipts will not be printed on the back of your badge.
Cancellations can be made up to November 9, 2016. An administrative fee of $25 will be deducted from your refund check. No refunds will be made after this date.
Payment Information
Attendee Name _____________________________
Conference Registration Fee $___________Special Events Total Fee $ __________Total Payment Due $ __________
Mail Form and Payment to: NJASL Conference Registrationc/o C.H. Lopez Educational ConsultingP.O. Box 247Metuchen, NJ 08840Fax: 732-548-0003Email: [email protected]
NJASL 2016 Fall Conference Registration FormOcean Place Resort, Long Branch, New Jersey
November 17 - 19, 2016
Author’s Luncheon, Nov. 17, 12:00-1:15pm $37Featured author Trinka Hakes Noble. Includes PD Certificate. Event limited to 150 attendees! Opening General Session, Nov. 17, 3:00-4:15pm FreeKeynote presentation by Dr. Leslie Maniotes. Includes PD certificate!Exhibit Hall Opening, 4:30-6:00pm FreeSee what amazing things the exhibitors have in store for you and your school library. Play Vendor Bingo! Raffles and light refreshments.Retiree’s Reception, Nov. 17, 6:00-7:00pm $15Come visit with old and new retirees!County President’s Mixer, Nov. 17, 6:00-7:00pm FreeThis is your chance to meet your County President and peers who can support you during the year. General Session & Membership Meeting, Nov. 18, 8:30-10:00am FreeKeynote presentation by Kwame Alexander. Includes PD certificate.Q&A With Kwame FreeCome prepared with questions. PD certificate included. Limited to 100 - ticket required.Boxed Lunch in Exhibit Hall, Nov. 18, 12:00-1:00pm FreeCome eat and visit with our Exhibitors! Get your Vendor Bingo card stamped. Raffles!Evening of Fun, Nov. 18, 8:00-10:00pm $20 Join us for Islands music, desserts and fun!Continental Breakfast, Nov. 19, 8:00-9:00am $20You’ll need a good breakfast to prepare you for Maker Morning!Luncheon with Panel, Nov. 19, 12:15–2:00pm $35Panel discussion on creativity and collaboration, and Enthusiastic Reader Celebration! PD Certificate.
Attending Amount Due$_________
$__________
$ __________
$___________
$ __________
Total Events Fee $__________
Special Event TicketsProfessional Development sessions run Thursday, Friday and Saturday. See website for detailed schedule. For Special Events listed below, please check appropriate box for each event you will be attending so we can get an accurate headcount, and calculate total fees.
Postmark Date: PO Number: PO Date: PO Amount:
Confirmation On: Check Number: Check Date: Check Amount:
For Internal Use Only:
Special Accommodation RequestsIf you have a special physical or communication need, please contact Elizabeth McArthur, [email protected], to discuss no later than November 10, 20163.