Conference 2009 Registration Form
Second Languages: Passports to the Future
Greenwood Inn, Calgary, October 23-24, 2009
Tel: 403-250-4585 Fax: 403-250-8050 Toll Free: 1-888-233-6730
3515-26 Street NW, Calgary, Alberta Website: www.greenwoodinn.ca
Name: (please print clearly)
Mailing Address:
City: / Province: / Postal Code:
Home Phone: / Bus. Phone: / Fax:
E-mail (please print clearly)
School: / School District:
Alberta Teacher Certificate Number:
PLEASE INDICATE IF YOU HAVE ANY FOOD ALLERGIES:
Category of Membership in the Alberta Teachers’ Association (Check One)
ATA Membership Status: / Active / Associate / Life / Student OR Non-Member
Please note: Central office staff who did not elect active ATA membership cannot be members of specialist councils. The superintendent, deputy superintendent of school jurisdictions and teachers in charter, federal or private schools must be ATA Associate members in order to qualify for specialist council membership.
Conference Registration Fees
Registration fee includes Friday evening reception, all sessions, breakfast, lunch, 2 snacks and CASLT membership but it does not include membership in the SLIC. Please check one:
Regular Registration (postmarked by Oct. 9, 2009) / $200.00
Persons ineligible for Specialist Council Membership (see note above) / $400.00
Student Rate / $60.00
Non-Member (Retired, Advisors, Consultants) / $150.00
Group Rate (4 people from the same school or location) / $500.00
SLIC Membership: Unless you are ineligible for Special Council Membership, you must have a current membership in the SLIC to attend the conference by renewing or choosing new Automatic Specialist Council membership online at www.teachers.ab.ca or purchasing a membership in the council.
I choose SLIC as my Automatic Specialist Council Membership—September 1, 2009 to August 31, 2010. (please check if applicable) $ 0.00
Regular Membership (if SLIC was not your choice for no-cost membership) / 1 year / $30.00
Subscription Membership / 1 year / $50.00
Student Membership / 1 year / $10.00
Retired Teachers / 1 year / $25.00
Total Fees Due: Registration Fee + Membership or Subscriber Fee (if applicable) $
Make cheque payable to: SLIC Conference 2009
Walk-ins will be accepted at the conference IF space is available (Registration will be capped at 220 participants) $250.00
Cancellation Policy
A $50 non refundable administration fee will be charged for cancellation. All cancellations must be made in writing before October 12, 2009. No refunds after October 12, 2009. NSF cheque $40.00. / Confirmation of Registration
Will be provided by e-mail only upon receipt of payment and verification of ATA membership. Receipts will be included in your registration package available at the registration desk. / Hotel Reservations
Please reserve your room directly with the hotel and quote SLIC to receive the negotiated $109.00/night. Only 30 rooms have been pre-booked and guaranteed at this rate.
Parking on site is Free. / Insurance
The Council and its conference committee are not insured to meet claims from any incidents during the conference. It is your responsibility to be properly insured for personal injury, sickness, etc. / Please Note
In making application for membership or subscription in a specialist council, you are voluntarily providing your personal information and consenting to its collection, use and disclosure for all purposes connected with your participation in the council.
Permission for photos to be taken during the conference (Please check one):
I agree to have my photo taken during the conference for possible inclusion in the SLIC newsletter and/or website.
I do not agree to have my photo taken during the conference for possible inclusion in the SLIC newsletter and/or website.
PLEASE SUBMIT COMPLETED FORM AND FULL PAYMENT TO CONFERENCE REGISTRAR: / GENERAL INQUIRIES or INFORMATION: (If you have questions about your eligibility in the ATA, please contact the ATA at: 780-447-9400 or toll free at 1-800-232-7208)
Name: Theresa Trapnell
Phone: 403-283-0545
Fax: 403-500-2935
Address: #203,835-18th Ave. SW, Calgary, T2T 0G9
E-mail: / Heide Doppmeier (Conference Director)
School Phone: 403-281-3366 ext. 7037
Fax: 403-777-7999
Address: 176 Harvest Gold Circle NE, Calgary, T3K 4H4
E-mail: