2018 Share the Wealth

2018 SHARE THE WEALTH

PHYSICAL EDUCATION CONFERENCE

January 25-27, 2018

Pre-Registration Form

Pre-Registrations must be postmarked by January 10, 2018. After this date, attendees must register on-site at the Convention Center.

______

Name
Position/Title
School/Organization
BUSINESS ADDRESS
Street or P.O. Box
City
State
Zip
HOME ADDRESS
Street or P.O. Box
City
State
Zip
Phone
(Include Area Code)
Work #
Home#
Cell #
Fax #
Email
Email
Please check one of the following:
( X ) Pre-registration for full conference ($100)*
( ) Pre-registration for Saturday only ($75)*
( ) Pre-registration for Full Time Student ($40)*
*If received or postmarked by January 10, 2017

*NOTE: Only those who pre-register will be guaranteed all conference materials including the official program.

Requests for refunds must be submitted in writing prior to January 5, 2018 and will not be processed until after the conference. A $25 processing fee will apply. Please direct any questions concerning registration to Kim Thompson at or

770-852-1543.

Please Mail Completed Form To:

GAHPERD SHARE THE WEALTH

C/O KIM THOMPSON

9360 HIGHWAY 166

WINSTON, GA 30187

THANK YOU!