2015 AEA LEADERSHIP CONFERENCE – REGISTRATION and WORKSHOP SELECTION FORM

Please PRINT the information below and return this form, with the $25.00 registration fee for each person, to Darryl Sinkfield, AEA, P. O. Box 4177, Montgomery, AL 36103-4177 by June 5. Please use one form for each person. Make checks or money orders payable to AEA.

1. NAME: ______________________________________________________________________________________________________

2. ADDRESS: _________________________________________ CITY: ______________________ STATE: _____ ZIP: _________

3. PERSONAL EMAIL ADDRESS (If applicable): ______________________________________________________________________

4. PHONE include area code (Work): __________________________ (Home): ____________________________________________

5. LOCAL ASSOCIATION – Please Do Not Abbreviate: ________________________________________________________________

6. IS THIS YOUR FIRST TIME TO ATTEND THE LEADERSHIP CONFERENCE? Yes: __________ No: __________

1. Thursday, June 11, 1:30 p.m. – 3:00 p.m. – Division Representative Assemblies – Select the Division Assembly you will participate in:

____ ACT (RA will be 10:00 a.m. – 3:00 p.m.) _____ Administrator _____ ESP Rep Assembly ____ Postsecondary

2: Thursday, June 11, 3:15 p.m. – 5:15 p.m.: Select three in first, second and third order of preference:

____ Training for Experienced Presidents/Vice Presidents _____ Training for Secretaries

____ Training for NEW Presidents/Vice Presidents _____ Training for Treasurers

____ Membership Recruitment and Member Involvement

3: Friday, June 12, 8:00 a.m. – 9:45 a.m.: Select three in first, second and third order of preference:

____ Politics All Around Us – A Legislative Update ____ Generation Next Leaders

____ Changing the Culture of Your Local – Member-to-Member ____ Member Benefits – Savings Worth the Cost

____ Special Education: Dyslexia Bill of Rights for Students ____ The Power of Participation

____ Building Association and Community Collaboration

4. Friday, June 12, 9:50 a.m. – 11:35 a.m.: Select three in first, second and third order of preference:

____ Politics All Around Us – A Legislative Update ____ Be the News – Don’t Make the News

____ Hands off – TNT! ____ PEEHIP – What’s Next

____ Human Trafficking – Prevention at the School Door ____ True Colors (formerly The Power of Participation)

____ Building Association and Community Collaboration

5: Friday, June 12, 11:40 a.m. – 1:25 p.m.: Select three in first, second and third order of preference:

____ Generation Next Leaders ____ Be the News – Don’t Make the News

____ Changing the Culture of Your Local – Member-to-Member ____ Special Education: Dyslexia Bill of Rights for Students

____ The Charter School Bill – It Will Affect You ____ True Colors (formerly Collaborate or Die)

____ PEEHIP – What’s Next

6. Saturday, June 13, 8:00 a.m. – 9:30 a.m.: Select three in first, second and third order of preference:

____ Professional Issues Organizing ____ Laws That All Public Education Employees Must Know

____ Human Trafficking – Prevention at the School Door ____ The Charter School Bill – It Will Affect You

____ Fiduciary Responsibilities for Local Officers

7. Saturday, June 13, 9:35 a.m. – 11:05 a.m.: Select three in first, second and third order of preference:

____ Professional Issues Organizing ____ Laws That All Public Education Employees Must Know

____ Hands off – TNT! ____ Member Benefits – Savings Worth the Cost

____ Say What? Fundamentals of Great Public Speaking

8. Friday, June 12, 3:30 p.m. – 5:00 p.m. – mark each as it applies:

I will participate in the Wellness Screening: _____ Yes or _____ No Spouse Participation: _____ Yes or _____ No

9. Meal Participation – Check each meal that you will participate in: _____ Thursday, June 11, Banquet _____ Friday, June 12, Luncheon

Registration fee is the same regardless of meal participation.