2015 TFLTA CONFERENCE REGISTRATION FORM
MUST BE POSTMARKED BY OCTOBER 26, 2015
Please submit either this form to register for the conference OR the membership update form if not attending.
Complete and return form with a postmark no later than October 26, 2015to:
Fräncille Bergquist, 9114 Sawyer Brown Road, Nashville, TN 37221.
All registrations must include full payment by check or money order, payable to “TFLTA”.
Cancellation fee: $10.00 until 2 November2015. After 2 November2015, no refund is possible.
Pre-registration for meals and workshops is strongly advised. Some on-site tickets may be available for an additional cost.
FIRST TFLTA CONFERENCE? ______NEW MEMBER? _____
Name (as you wish it to appear on your name tag): ______
Address (indicate if home ____ or work ____): ______
City: ______State: ______Zip Code: ______
Phone(indicate if home ____ or work ____): (______)______
E-mail address: ______School Name______
Language(s) Taught (indicate all that apply): CHIN FREN GERM JAPN LATN SPANOTHER: ______
Level (circle all that apply):FLES/ELEMMID/JR HIGHSR HSCOMM COLLUNIVADMINSTUDENT
REGISTRATIONAND DUES:AMOUNT ENCLOSED
2016 DUES (Required unless you are a life member, student, or retiree)$25.00______
PATRON(Includes 2016 dues, but not registration fee)$50.00______
LIFE MEMBERSHIP (______Check here if already a life member)$200.00______
PRE-REGISTRATION(Saturday breakfast included) (Postmarked by October 26, 2015)$65.00______
REGISTRATION(Saturday breakfast included) (Postmarked after October 26, 2015)$75.00______
STUDENT/RETIREE PRE-REGISTRATION (Postmarked by October 26, 2015)$50.00______
STUDENT/RETIREE REGISTRATION (Postmarked after October 26, 2015)$60.00______
(Note: Student/Retiree registration also includes Saturday breakfast and dues for 2016)
WORKSHOPS (Descriptions available at ENCLOSED
Friday, November 6, 2015, 9:00 – 12:00 a.m. (Select ONE)
_____French*: Libre et Laïque – une tradition française$40.00______
* Current AATF members receive a $10.00 discount on the French workshop$30.00______
_____General I: Teaching in the Real World: Easy-to-use Tips and Strategies$40.00______
_____General II: World Languages Portfolio: How to Survive, How to Succeed$40.00______
_____General III: Praxis II Preparation for New Teachers$40.00______
_____Latin: Vergil’s Aeneid through the Camera’s Eye$40.00______
_____Spanish:Hispanic Studies through Film and Literature$40.00______
MEALS: AMOUNT ENCLOSED
Friday Night AwardsBanquet$47.00______
Saturday Language Luncheons: (circle one) $35.00______
AATF* AATG TCA AATSP* NNELL CHINESE
* French teacherswho participated in the 2015 National French Contest and Spanish teachers who participated in a 2015 program of the AATSP receive discounts for the luncheon. You must include the coupon being sent to you via email entitling you to the discount. Contact your AATF contest administrator or AATSP chapter president if you have any questions.
______Check here for vegetarian menu (No extra charge. No other substitutions to meals can be made.)
CONTRIBUTION TO Aliene ClickProfessional Development Fund$______
TOTAL ENCLOSED (Make check payable to “TFLTA”)$______