2011 Agricultural Education & IACTE Conference Registration

"Essential Questions For Agricultural Education Programs"

Agricultural Education Summer Conference - June 28 - 30, 2011
IACTE Conference - June 27, 2011
Iowa FFA Enrichment Center, Ankeny

Hotel: Reservation deadline is June 6th. This will NOT be done automatically! You will need to make your own reservation.

Courtyard by Marriott Ankeny - Hotel Phone Number: 1-800-321-2211.
www.marriott.com/dsman

BEFORE clicking "SUBMIT", PRINT a copy of this completed form for your records. Conference registration deadline is also June 6th if you want conference name tags, packets, printed materials etc.

Make PO and checks out to:
IAAE Conference Account

Send purchase orders and checks to:
Barbara Lemmer, IAAE Conference Coordinator
PO Box 5, Troy Mills, Iowa 52344
Name: 


A red asterisk (*) indicates required questions.

  1. Name


  1. School/College Name*


  1. Address of School/College *


  1. City *


  1. State *


  1. Zip *


  1. Email Address*


  1. Phone Number*


  1. Agricultural Educator Cell Phone*


  1. Business Manager Name*


  1. Business Manager Email Address*


  1. Business Manager Phone Number*


  1. Fax Number *


  1. If PURCHASE ORDER, please enter the PO NUMBER.


  1. T-shirt size*
    Small
    Medium
    Large
    Extra Large
    2XL (XXL)
    3XL (XXXL)


  1. Will 2011-2012 be your first year of teaching agricultural education?
    Welcome to the profession!
    Yes
    No


  1. Are you a current IAAE member?*
    Yes
    No


  1. YEARS OF EXPERIENCE:
    As of July 1, 2011, years employed as an Agricultural Educator. (numbers no words)

    *


  1. I plan to attend the IACTE CONFERENCE on Monday, June 27, 2011.

    The IACTE CONFERENCE, Education That Works!, will be held at the FFA Enrichment Center the day prior to the AgEd Summer Conference.

    Note: Jason Glass, new Director Iowa Department of Ed, will present at the IACTE conference. (Team Ag Ed needs to be well represented.)

    Note: IACTE Conference (Monday) is NOT part of the FULL Ag Ed Conference registration.*
    I plan to attend the IACTE Conference - $85.00.
    I do NOT plan to attend the IACTE Conference.


  1. FULL Ag Ed CONFERENCE REGISTRATION (3 DAYS)

    Select the rate. (below).
    ALL MEALS INCLUDED.

    SINGLE day registration rates below. The FULL Conference rate covers ALL days.
    IAAE member -- $175.00
    Non-member -- $225.00


  1. TUESDAY ONLY REGISTRATION

    Select appropriate rate below.

    Tuesday meals included.
    IAAE member -- $85.00
    Non-member -- $100.00


  1. WEDNESDAY ONLY REGISTRATION

    Select appropriate rate below.

    Wednesday meals included.

    IAAE member -- $90.00
    Non-member -- $105.00


  1. THURSDAY ONLY REGISTRATION

    Select appropriate rate below.

    Thursday meals included.
    IAAE member -- $85.00
    Non-member -- $100.00


  1. IAAE Instructional Materials Packet
    To Order (select rate):

    (For details, contact Jim Green, Riceville HS - jgreen@riceville.k12.ia.us)*
    IAAE member -- $125.00
    Non-member -- $150.00
    I do NOT plan to purchase a packet.


  1. CREDIT - AEA RELICENSURE or DRAKE GRADUATE credit

    If you select "plan to enroll", an mail with registration information and payment options to follow.
    I plan to enroll for AEA-relicensure ($25 approx.)
    I plan to enroll for Drake Graduate Credit ($90 approx.)
    I do NOT plan to enroll for credit.


  1. SPOUSE or GUEST REGISTRATION -- BELOW
    IF NOT NEEDED, SCROLL TO QUESTION #33.

    SPOUSE OR GUEST NAME(S) (separate names with a COMMA)


  1. Number of "EXTRA" TUESDAY NOON LUNCHES you wish to order @ $15 each.


  1. Number of "EXTRA" TUESDAY EVENING - PICNIC MEALS you wish to order @ $15 each.


  1. Number of "EXTRA" WEDNESDAY BREAKFASTS you wish to order @ $15 each.


  1. Number of "EXTRA" WEDNESDAY NOON LUNCHES you wish to order @ $15 each.


  1. Number of "EXTRA" WEDNESDAY EVENING - BANQUET MEALS you wish to order @ $25 each.


  1. Number of "EXTRA" THURSDAY BREAKFASTS you wish to order @ $15 each.


  1. Number of "EXTRA" THURSDAY NOON LUNCHES you wish to order @ $15 each.


  1. I plan to attend the NEW TEACHER WORKSHOPS.

    Starting Monday, June 27 @ 9:30am

    PRACTICAL suggestions to get your teaching career off to a good start and more! (presenters: Tiffany Johnston and Tara Fastert)
    Yes
    No


  1. 9 HOLE BEST SHOT GOLF TOURNAMENT - MONDAY, late afternoon

    Course and cost To Be Determined. Contact Mark Williams, Pella HS, for more details. pchsmaw@pella.k12.ia.us
    I plan to GOLF MONDAY afternoon.
    I do NOT plan to participate in golf.


  1. Have you retired from agricultural education during the 2010-2011 school year? Congratulations and good luck with retirement!
    Yes
    No





Barb Lemmer