2022-23 MNIAAA New Administrator Workshop
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NIAAA Member # (if known, if not enter UNKNOWN) *
First Name *
Last Name *
Date of Birth *
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School E-Mail *
Region *
Administrative Region
Yrs of Service as Activities/Athletic Administrator *
School Name *
School Address *
School City *
School State *
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School Zip Code *
Payment Method *
The New AD Workshop includes 2021-22 MNIAAA and NIAAA dues, LTC 501 and 502 classes, and three meals. Payment is $330 if by check. If you choose the credit card option, fees are added, your cost will be $350.00. Send check payable to: MNIAAA c/o Ken Hubert, 721 Ravine St., Faribault, MN 55021. If you would like an invoice or a receipt, please e-mail Ken at khubert55@gmail.com.  
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