30th Annual Texas Alliance of Black School Educators Conference Registration Form Houston Marriott Westchase Feb 25 – Mar 1, 2015 2900 Briarpark Drive, Houston TX, Phone 1.800.452.5110 “TABSE It Is Time to R.I.S.E. Space City is Blasting Off to New Heights in STEM Education” VIP/Early Bird Registration Begins October, 2014 REGISTRATION INSTRUCTIONS 1) 2) 3) 4) 5) 6) 7) TYPE or PRINT clearly all responses on this form VIP Registration begins Oct. 2014 ends Dec. 1, 2014 DO NOT SEND CASH Requests for refunds must be made in made in writing and postmarked no later than Dec 15, 2014 to be given consideration. Your badge name, full name and organization will appear on your badge and registration documents exactly as indicated below. Student membership/registration category applicable only to fulltime students who are NOT employed. Valid student identification card must be presented on-site or higher registration rates will apply. Members with outstanding membership dues must complete and submit a membership renewal application. Persons whose membership dues are delinquent will be charged the Non-Member registration rate. Personal Information Name: Prefix First MI Last This form covers only ONE conference attendee Please choose the appropriate conference registration rate QTY Individual TABSE Member (Includes All ticketed Conference Events) Individual Non Member (Includes All ticketed Conference Events) Retirees/Student TABSE Member (Includes All ticketed Conference Events) Retirees/Students Non Member (Includes All ticketed Conference Events) Single Day Conference Registration Full Time College Student VIP/ Early Bird Oct 2014 $200 REGULAR After 11/15/14 Rates LATE/ONSITE After Jan 1, 15 Rates $300 $350 $250 $350 $400 $100 $200 $250 $150 $250 $300 $125 $125 $175 $175 $50 $50 $75 $90 $105 $50 $35 $50 $90 $105 $125 $75 $50 $50 Pre-Conference Event - Dining with Divas Wednesday Dinner (Thursday – Opening Session) Founders Luncheon - Friday Annual Banquet - Saturday Parent Symposium - Saturday Youth Symposium - Saturday TABSE Membership $50 Representation (select only one) Badge Name (Nickname) Position/Title District/Organization/Company City/State/Country Special Needs _____Yes _____ No Check if you have special dietary needs ___________________ * only pre-registration requests will be honored during meals District Administration Full Time College Student Local School Administration Parent Retiree Student Grade ____ Superintendent Payment Information: Mailing Address ❑ Master Card ❑ VISA City State Zip Home: Phone Fax Work Number Cell Phone Number ❑ Money Order: Teacher ❑ Check ❑ P.O. (Purchase Order) Number:________ Other Cardholder’s Name (Required): _____________________________________ Credit Card No.: ________________________ Exp. Date:_____________________________ Auth Code:____________________________ Signature:_____________________________ Required for Credit Card Authorization Please send completed application & Payment to: 2015 TABSE Conference – c/o Dr. Elaine Bailey 3100 Richmond Avenue, Suite 306 Houston, TX 77098 (ph) 713-529-3305 (fax) 713-529-2446 e-registration: www.tabse.net or www.haabse.org Total Enclosed: $____________________ TABSE Office Use Only I.D.# Date Rcvd: Total Amt. Due: Total Received: Balance/Refund: Confirmation/Invoice Mailed Payment Type: Invoice Mailed: Y N VIP SPECIAL: The first 150 individuals with Early Bird full registrations, who will be considered as a VIP: ADVANTAGES: No waiting in line for registration Reserved table for meal functions Special Red Carpet Photo Admission to VIP Hospitality Suite Special VIP Welcome Gift Special VIP ID The Texas Alliance of Black School Educators is a 501(c)(3) tax exempt nonprofit organization 30th Annual Texas Alliance of Black School Educators Conference Registration Form Houston Marriott Westchase Feb 25 – Mar 1, 2015 2900 Briarpark Drive, Houston TX, Phone 1.800.452.5110 “TABSE It Is Time to R.I.S.E. Space City is Blasting Off to New Heights in STEM Education” REGISTRATION POLICIES • • • • • VIP status available only to the first 150 full registrants. The VIP Special does not apply to the Single Day rate. All registration fees must be paid in full prior to receiving conference materials. Conference badges must be worn in order to gain access to all functions. Online conference registration is available at www.haabse.net through February 2, 2015 - BY CREDIT CARD ONLY. • • • • • • • On-Site Registrants must come to the On-Site Registration booth to make any required payment in order to receive registration materials and conference credentials. *Bags, registration materials and meal tickets are limited and may not be available NO PERSONAL CHECKS will be accepted on-site for any conference fees including registration, luncheon tickets, etc. under any circumstances. Declined credit cards may result in delayed registration. Attendees will not gain access to conference activities without remitting full payment and displaying conference credentials. Requests for refunds must be made in made in writing and postmarked no later than Jan 21, 2015 to be given consideration. Emails, faxes and verbal refund requests will not be accepted. Absolutely no refunds will be considered after the Jan 21, 2015 deadline. A $50.00 service charge will be assessed on all refund requests. A $50.00 fee will be assessed for all returned checks. Registration transfer requests must be submitted in writing by January 25, 2015. A $50.00 fee will be assessed to transfer registration from one individual to another. The Texas Alliance of Black School Educators is a 501(c)(3) tax exempt nonprofit organization
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