30th Annual Texas Alliance of Black School Educators Conference Registration Form

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
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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)
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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:
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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
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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.
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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