2015 MIAAA Annual Conference Registration Form  
Conference Dates - Friday March 20 - Tuesday March 24, 2015

ADMINISTRATIVE ASSISTANT/SECRETARY MUST REGISTER SEPARATELY
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Certification Level *
Required
School Name *
If you are a retiree- please put retiree in this blank
School Town *
If you are a retiree - use your residence town
School Address and Zip Code *
If you are a retiree - use your residence address & zip in this blank
School Phone Number *
If you are a retiree - use your best contact number in this blank
Email *
Email address will be used on business cards
Athletic Administrator *
Attending conference as AD, including conference gift, business cards, name badge, conference banquet
Required
Administrative Assistant (Secretary) *
Attending conference as AD Assistant / Secretary, including conference gift, business cards, name badge
Required
Spouse or Guest *
Attending conference with AD or AD Assistant/Secretary, includes name badge, specific activities as listed
Cost of Conference Attendance *
Select appropriate cost
Required
Name of Spouse or Guest
Include First & Last Name
Extra Name Badge *
If you have a spouse or guest not participating in specific activities - but want to go into Exhibits - this is needed
Required
Name on Extra Name Badge
Only if needed - include first & last name - will cost extra
Cost of Conference After February 20, 2015 *
Select the appropriate cost - you will be required to pay if your payment & registration are not before the deadline
Required
Will you be attending the Conference Award Banquet on Sunday evening? *
We need to best estimate our meal count with the day change - your answer will assist us
Total $$ to be submitted with registration form to George Lovich *
before you complete this box - print form (use control P with PC or command P with MAC)
Make Checks or Money Orders out to MIAAA
Send to George Lovich, 41442 Parkside, Canton, MI 48187
Office Use Only
do not use
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms