TOEA Registration Form
Name (First and Last Name)
Your answer
School/Organization
Your answer
Teaching Area & Grade or Job
Your answer
Mailing Address (including city, state, & zip code)
Your answer
Preferred Telephone Number
Your answer
Preferred E-mail Address (Personal/Non-work to help ensure delivery of TOEA information)
Your answer
Gender
Are you seeking TEEAC Credit
Special Roommate Requests (same gender) (Roommate requests must be indicated on this form but there is no guarantee unless all forms are received together.)
Your answer
In Case of Emergency Contact (Name, Phone Number, & Relationship)
Your answer
Do you have any medical conditions that our staff should be aware of? If so, please briefly describe:
Your answer
How did you learn about TOEA?
Your answer
TOEA is not able to meet all unique dietary requirements of all participants. Please review the menu which will be posted on the website prior to the workshop and bring any special foods needed to meet your specific dietary requirements. REGISTRATION FEE INFO: The workshop fee includes two nights lodging, 6 meals beginning with Friday night through Sunday noon, as well as TOEA dues and newsletters for one full year.
If you have a dietary restriction, please describe below:
Your answer
PLEASE NOTE: ****NO PURCHASE ORDERS ARE ACCEPTED FOR REGISTRATION****

When your registration is received, you will be sent confirmation either by email or snail mail, directions to the camp, and a list of essentials to bring. If you do not hear from the registrar, please call to make sure your form has been received. The deadline for registration is September 23, 2017. Registration will close if workshop capacity has been reached before that date. All registrations received after the workshop is filled will be notified and placed on a waiting list. NO REFUNDS WILL BE MADE AFTER SEPT. 23rd. Dues are NON-REFUNDABLE. Late registration may be made by email (sallymac@windstream.net) until 5:00 p.m. CST on September 25th. Fees must be paid at the time of registration at the workshop in order to attend.
Are you a presenter at this TOEA Workshop?
Payment (Includes 1 year membership for TOEA & Workshop costs-food, lodging, & sessions):
Required
Pre-order T-shirts (Order by August 15th to guarantee size)....$12 each and $14 for XXL & XXXL
Total Amount for Registration:
Your answer
If an organization/school is paying for your registration then please tell us who:
Your answer
If using a school issued check, please put names of teachers attending workshop on the check. Thanks.
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