Complete Package - American Federation of Teachers

38TH ANNUAL AFT PARAPROFESSIONALS AND SCHOOL-RELATED PERSONNEL CONFERENCE
Washington Hilton » Washington, DC.
FIRST-AID TRAINING OF TRAINERS » APRIL 15-17
PSRP JUMP-START » APRIL 16-17
PSRP PROFESSIONAL ISSUES CONFERENCE » APRIL 17-19
Please type or print. Online registration is available at go.aft.org/PSRP2015.
Note: If registering using this form, a separate form is required for each participant.
Name: __________________________________________________ Name for Badge: ____________________________
Local/Organization Name: __________________________________
Local Number: ______________________________
Job Title: ______________________________________________________________________________________________
 AFT Member
 Non-AFT Member
Indicate if this address is:  Home
 Local/State Staff
 Work
 State/Local Union
Preferred Mailing Address: _______________________________________________________________________________
City: _________________________________________________
State: ____________________ ZIP: ____________
Work Number: _____________________ Home Number: ____________________ Cell Number: ___________________
E-Mail: _____________________________ Fax Number: ________________________________
REGISTRATION DEADLINES:
Early Bird, by March 11 Regular, by March 20 Late, after March 20 Registration fees to be paid by:
 Individual
 Member’s Local
FEES:
 $85
 $90
 $95
 Other (specify): ___________________________________________
The AFT is providing one free registration fee per local,
so calculate your total accordingly. (Excludes PPC member locals.)
Form of payment:
 CHECK—enclosed for $____________________.
MAIL THIS REGISTRATION FORM WITH
PAYMENT INFORMATION TO:
American Federation of Teachers / PSRP 2015
Attn: PSRP c/o Michawn Blakeney
555 New Jersey Avenue NW
Washington, DC 20001
Name (as printed on check): _________________________________________________________.
Make check payable to AFT and mail to: American Federation of Teachers, P.O. Box 791212, Baltimore, MD 21279-1212.
Cardholder’s Name (print):___________________________________________
Amount Paid: $ ______________
Credit Card Number:
Exp.:
____________________________________________
_______/_______
(MasterCard or Visa accepted)
Cardholder’s Billing Address: ___________________________________________________________________________
Cardholder’s Signature: _______________________________________________________________________________
These sessions are open to all conference participants, but they require pre-registration and
are on a first-come, first-served basis. We will do our best to accommodate you.
PSRP Conference Jump-start
Please let us know if you plan to attend Part I, Part II or both.
 Part I, Fighting Forward: Together We Are Stronger—Thursday, April 16, from 2 p.m. to 5 p.m.
 Part II, Fighting Back: Changing the Narrative—Friday, April 17, from 9 a.m. to noon
 Parts I and II—Fighting Forward and Fighting Back
Job Group Discussions:
(Please indicate which job group discussion you will be attending)
 Custodians, PreK-12 and College Systems
 Financial and Accounting in PreK-12 Central Administration
 Financial and Administrative in College Systems
 Maintenance and Skilled Crafts, PreK-12 and College/University
 Security and Campus Police, PreK-12 and College/University
 Food Service/Child Nutrition
 Transportation/Bus Drivers
 Secretary/Clerical, PreK-12 School-Based
 Technical and Student Services, College/University
 Paraprofessionals
____ Community and Parent Liaisons
____ Computer Labs
____ Elementary Classrooms
____ Health Room
____ Media Centers
____ Middle and High School Classrooms
____ Pre-K, Early Childhood and Head Start Programs
____ Working in Title I Programs
____ Working with Children with Autism
____ Working with Students with Behavioral Disorders
____ Working with Students with Severe or Profound Physical Disabilities
____ Working with English Language Learners
SPECIAL NOTE: Hotel reservations must be made separately on the forms provided. Do not contact the
Washington Hilton directly to make reservations. You can access hotel reservation forms online at
go.aft.org/PSRP2015.
Questions? Call us at: 800-238-1133, ext. 4696, or e-mail: [email protected].
38TH ANNUAL AFT PARAPROFESSIONALS AND SCHOOL-RELATED PERSONNEL CONFERENCE
Conference Costs
1. REGISTRATION FEE: $90 ($85 early bird, before March 11).
The registration fee includes:
■ All conference materials and a canvas briefcase
■ Friday evening reception following the general session (there is a small charge for drinks)
■ Saturday morning continental breakfast
■ Saturday luncheon
2. HOTEL ROOM RATES
We hope you find this chart useful when estimating costs for attending the PSRP Conference. To help you budget costs,
we have also indicated the per-person rates for double, triple and quad rooms. Please note that all rooms contain either
one king bed or two double beds. A rollaway can only be added to a room with a king bed, at $35 for your entire stay.
The room rates listed below include a 14.5 percent sales tax.
Washington Hilton
1919 Connecticut Ave. N.W.
Washington, DC 20009
Room Rates:
One night
Two nights
Three nights
Four nights
Single (one adult in room)
$239.31
$478.62
$717.93
$957.24
Double (two adults)
Per Person
$239.31
$119.66
$478.62
$239.31
$717.93
$358.97
$957.24
$478.62
Triple (three adults)
Per Person
$267.93
$ 89.31
$535.86
$178.62
$803.79
$267.93
$1071.72
$357.24
Quad (four adults)
Per Person
$296.56
$ 74.14
$593.12
$148.28
$889.68
$222.42
$1186.24
$296.56
3. QUESTIONS?
Contact Michawn Blakeney in the AFT PSRP department at 800-238-1133, ext. 6326,
or at [email protected].
38TH ANNUAL AFT PARAPROFESSIONALS AND SCHOOL-RELATED PERSONNEL CONFERENCE
Hotel Reservation Instructions and Information
*** Hotel reservations can now be made online at go.aft.org/PSRP2015conf. However, you can still reserve your hotel
room by completing and returning the hotel reservation forms (please refer to the instructions below).
1. Deadline: All hotel reservation requests must be made on the Hotel Reservation Form and Conference Rooming List. The hotel
reservation deadline is Wednesday, March 11. Phone reservations will not be accepted. Please type or print clearly, and fill in the
form completely. Reservations cannot be made without all the requested information. After the deadline, unused rooms will be
released back to the Washington Hilton and may not be available at the conference rate.
2. Send reservation forms to: AFT/PSRP Conference Housing
555 New Jersey Ave. N.W., Washington, DC 20001
OR fax to the AFT Meetings and Travel Department at 202-879-4558
3. Guarantee/Deposit: The Washington Hilton requires a one night’s room and tax deposit.
By credit card: Locals that wish to use a credit card for their participants must complete the enclosed credit card authorization form
and return it with the other reservation forms.
By check: If a personal check is used as your deposit for the first night’s room and tax (made payable to Washington Hilton), it
should be sent in at the time the reservation is submitted, and it will only be refunded if the reservation is canceled at least 72 hours
prior to the arrival date. If the balance of your stay is being paid by check, we must receive it one week prior to your arrival date.
*** The hotel does not accept purchase or money orders.
4. Date Changes/Cancellations/Name Changes: Date changes, cancellations and name changes must be submitted in writing to
the AFT meetings and travel department by fax, mail or email (contact information is below under item 9).
5. Room Rates:
Per night
Including 14.5% tax
Single (one adult in room)
$209.00
$239.31
Double (two adults)
$209.00
$239.31
Triple (three adults)
$234.00
$267.93
Quad (four adults)
$259.00
$296.56
6. Parking: The Washington Hilton offers both self-parking and valet parking. Self-parking is $36/day and valet parking is $46/day.
7. Check-in and Check-out: The Washington Hilton check-in time is 4:00 p.m. and check-out time is 11:00 a.m.
8. Early Departure Fee: Guests checking out prior to their reserved check-out date will incur an early departure fee equal to one
night’s room and tax. Guests wishing to avoid an early departure fee should advise the hotel at or before check-in of any change in
their planned length of stay.
9. Questions? Contact Kim Randolph at 800-238-1133, ext. 4529 (or at [email protected]), or Karen Zook at 800-238-1133,
ext. 4476 (or at [email protected]), in the AFT meetings and travel department.
38TH ANNUAL AFT PARAPROFESSIONALS AND SCHOOL-RELATED PERSONNEL CONFERENCE
Hotel Reservation Form
PLEASE RETURN THIS ENTIRE FORM TO:
AFT/PSRP Conference Housing 555 New Jersey Ave. N.W., Washington, DC 20001 OR fax to the AFT meetings and travel department at 202-879-4558.
*** Deadline for hotel reservations is Wednesday, March 11.
1. NAME AND TITLE (CONTACT PERSON FOR ALL RESERVATION):
Local Name And Number: _______________________________________________________________________________
Address: _______________________________________________________________________________
City: _________________________________________________
State: ____________________ ZIP: ____________
Work Number: _____________________ Home Number: ____________________ Cell Number: ___________________
E-Mail: _____________________________ Fax Number: ________________________________
2A. INDIVIDUAL RESERVATION (ONLY 1 ROOM NEEDED)
Reservation for: ________________________________________________________________________________________
Sharing with: __________________________________________________________________________________________
Arrival Date: ________________________________________
 Single($239.31)
 Quad
 Double($239.31)
 1 King Bed
 Triple($267.93)
 2 Doube Beds
Departure Date: ______________________________
($296.56)
2B. GROUP RESERVATIONS (2 OR MORE ROOMS NEEDED)
Please use the conference rooming list form to indicate names, arrival and departure dates, and room requests.
Total Number of Rooms Needed: ___________________________
_____ # of Singles
($239.31)
_____ # of Doubles ($239.31)
_____ # of Triples
($267.93)
_____ # of Quads
($296.56)
FOR AFT USE ONLY:
_____________________ RECEIVED
_____________________ TO HOTEL
3. RESERVATION GUARANTEE
 BY CREDIT CARD
Cardholder’s Name (print):_______________________________________________________________________________
Credit Card Number:
___________________________________________________
Exp.:
_______/_______
(MasterCard or Visa accepted)
If the above credit card is being used to pay for the entire stay of the guest(s), and the cardholder will not be present, the cardholder will need to
complete and return the attached credit card authorization form.
 BY CHECK (Payable to Washington Hilton)
Check #:
___________________________________________________
Amount $:______________
4. SPECIAL REQUIREMENTS:
If any of your participants require special accommodations or services, please indicate them below.
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
38TH ANNUAL AFT PARAPROFESSIONALS AND SCHOOL-RELATED PERSONNEL CONFERENCE
Rooming List
*** Deadline for hotel reservations is Wednesday, March 11.
1. NAME OF ROOM OCCUPANT: ____________________________ Arrival Date:___________ Departure Date:____________
Sharing with: _____________________________________________ Arrival Date:___________ Departure Date:____________
Sharing with: _____________________________________________ Arrival Date:___________ Departure Date:____________
Sharing with: _____________________________________________ Arrival Date:___________ Departure Date:____________
ROOM REQUEST:  1 KING BED
 2 DOUBLE BEDS
1. NAME OF ROOM OCCUPANT: ____________________________ Arrival Date:___________ Departure Date:____________
Sharing with: _____________________________________________ Arrival Date:___________ Departure Date:____________
Sharing with: _____________________________________________ Arrival Date:___________ Departure Date:____________
Sharing with: _____________________________________________ Arrival Date:___________ Departure Date:____________
ROOM REQUEST:  1 KING BED
 2 DOUBLE BEDS
1. NAME OF ROOM OCCUPANT: ____________________________ Arrival Date:___________ Departure Date:____________
Sharing with: _____________________________________________ Arrival Date:___________ Departure Date:____________
Sharing with: _____________________________________________ Arrival Date:___________ Departure Date:____________
Sharing with: _____________________________________________ Arrival Date:___________ Departure Date:____________
ROOM REQUEST:  1 KING BED
 2 DOUBLE BEDS
IF YOU NEED ADDITIONAL SPACE, PLEASE MAKE COPIES OF THIS PAGE.
FOR AFT USE ONLY:
_____________________ RECEIVED
_____________________ TO HOTEL
Credit Card Payment Authorization Form
Please complete all areas below. Incomplete requests may be rejected. This form must be received at least 5 business days
prior to the Check-In, or by specified date in Event Contract, to ensure acceptance of the credit card to be charged. Do not
send completed form by email.
FAX COMPLETED FORM TO: (202) 879-4558
ATTN: Kim Randolph
Date: _________________
Guest / Group Name:
Check-In / Event Date / Confirmation Number:
Name of Person/Group Making Reservation:
Authorized Amount:
Phone:
Approval Code:
CARDHOLDERS - Please complete the following section and sign/date below.
Cardholder Name as it Appears on Credit Card:
Cardholder Billing Address:
City:
State:
Daytime /Business Telephone:
Credit Card Number:
Credit Card Type: (Circle one)
Visa/MasterCard
Credit Card Issuing Bank Name:
Date:
Zip:
Evening Telephone:
Expiration Date:
American Express
Discover
JCB
Bank Phone Number (from back of your credit card):
I agree to cover the following categories of charges: (Please circle)
All Charges
Room & Tax
Food & Beverage
AV
I agree to cover the above categories of charges up to a Maximum Amount of $ __________________
DIRECT BILL ACCOUNT PAYMENTS ONLY:
Name on Invoice/Statement
Diners Club
Miscellaneous
_______ ______ Date on Invoice/Statement
Invoice/Statement Number _________________________ ______________ Authorized Amount $_______________________
Note: Charges for room and tax, group deposits or direct bill account payments will be charged to your credit card
immediately. Any incidental charges circled above will be charged at the time of check-out.
Amount to be immediately charged to credit card for room and tax or deposit: $______________
Final Balance Billed to Credit Card (hotel use only): $_______________
By signing below, you authorize the hotel to charge your credit card immediately for the amount indicated above up to the “Maximum
Amount” indicated above. You further acknowledge that if “all charges” has been selected, then all guest/group related charges (less
Deposit) will be charged to the above card number at the time of check-out or event conclusion.
Cardholder Signature:
Date:
Trainers Wanted!
Once again this year, the AFT health, safety and well-being department is offering a First Aid, CPR and AED
Training of the Trainer class. Learn how to administer basic first aid, perform CPR and use an AED (automated
external defibrillator). Then, you’ll be ready to teach your co-workers back home the same skills.
By attending this three-day class, you can become a certified trainer with a certification card that is valid for
two years. THIS HANDS-ON PRE-CONFERENCE TRAINING is certified by the American Safety & Health
Institute. Participants will be required to pass a number of skills tests during the course to receive the certification. At the end of the class, participants who successfully complete the three-day training will receive a
card valid for two years indicating that they are certified to teach an eight-hour First Aid/CPR/AED class and
to issue cards of completion to the participants they train. Act fast, since this pre-conference class is limited
to the first 25 applicants!
If you are interested in attending,
contact Sabrina Simmons for
a registration form at
800-238-1133, ext. 5677,
or at [email protected].
PSRP CONFERENCE
WASHINGTON, DC
Wednesday, April 15 –
Friday, April 17, 2015
8:30 a.m. – 5:00 p.m.
38TH ANNUAL AFT PARAPROFESSIONALS AND SCHOOL-RELATED PERSONNEL CONFERENCE
Your Local
Union Wanted!
to the Rescue!
Trainers
Picture this:
Once again this year, the AFT health, safety and well-being department is offering a First Aid, CPR and AED
Training of the Trainer class. Learn how to administer basic first aid, perform CPR and use an AED (automated
A small PSRP local union …
external defibrillator). Then, you’ll be ready to teach your co-workers back home the same skills.
Its members facing many challenges …
They need help, they need training,Bythey
need ideas,
and they need
…
attending
this three-day
class, solidarity
you can become
a certified trainer with a certification card that is valid for
Training, ideas and solidarity they two
can only
get
at
the
AFT
PSRP
Conference!
years. THIS HANDS-ON PRE-CONFERENCE TRAINING is certified by the American Safety & Health
Institute. Participants will be required to pass a number of skills tests during the course to receive the certification. At the end of the class, participants who successfully complete the three-day training will receive a
card valid for two years indicating that they are certified to teach an eight-hour First Aid/CPR/AED class and
to issue cards of completion to the participants they train. Act fast, since this pre-conference class is limited
to the first 25 applicants!
Donate a gift card or basket for the raffle
at this year’s meeting and support
the PSRP Conference Scholarship Fund.
Help us bring a PSRP leader/activist to next year’s conference.
If you are interested in attending,
Funds raised from raffle sales will help a PSRP local that hasn’t been able to pay
contact Sabrina Simmons for
for conference attendance the last five years send someone to next year’s event.
a registration form at
800-238-1133, ext. 5677,
If you donate a gift card, please bring one that:
or at [email protected].
• Can be used anywhere in the country; and
• Is from a retailer that is public school and union friendly.
PSRP CONFERENCE
WASHINGTON, DC
A tisket, a tasket—you still can donate a basket!
–
If you want to stick with tradition Wednesday,
and donate aApril
gift 15
basket
Friday,great
Apriltoo.
17, 2015
that represents your state or city, that’s
8:30 a.m. – 5:00 p.m.
If you plan to send your gift card or basket donation
to the AFT, items must be received by Friday, April 3.
Please do not bring gift cards from
anti-public school or anti-union retailers,
such as Wal-Mart.
38TH ANNUAL AFT PARAPROFESSIONALS AND SCHOOL-RELATED PERSONNEL CONFERENCE