REGISTRATION
13th Annual TCES Science Leadership Symposium
January 15-17, 2010
YO Resort, Kerrville

Print, complete, and send registration form and payment to:
Texas Council of Elementary Sciences
c/o Gayle Evertson
11232 South Bay Lane
Austin, TX 78739

Please print clearly


Name _________________________________________________________________________

School/Institution: ________________________________________________________________

District:________________________________________________________________________

Campus Mailing Address:___________________________________________________________

City and Zip:______________________________________________             ESC Region ________

Gender (needed for room assignments): _____M _____ F

E-mail Address:__________________________________________________________________

Important: Please note that all conference correspondence will be done by e-mail. District spam filters may block important e-mails.

This Symposium is open to members of TCES. If not a current member, please include the $10 membership fee.
NO registration form will be accepted unless accompanied by check, money order, or PO.

Membership Fee:

( ) new         ( ) renewing $ 10.00

Current member
$      0


Symposium Registration Fee:

Symposium (Covers cost of lodging, meals, and materials) $175.00
Symposium ( If registering after 12/20/09) $200.00


Total Amount Enclosed:                                                                                     $_______________


No refunds after Janury 6, 2010.

Please note any dietary preferences/restrictions? ____________________________________


√ Check all that apply to your school/job setting:

____ Elementary _____ Middle _____ High _____ Informal Institution

The grade levels served by my school: ___________________________

I am a/an: Classroom teacher at grade(s)_________________

____ Science Specialist ____ Special Ed. Teacher ____ ESL/Bilingual teacher

____ Informal Science Educator ____ Fine Arts teacher ____ Consultant

____ Supervisor/Administrator ____College/University educator ____Pre-service teacher

Other ___________________________________________________________

√ How long have you been a member of TCES?

___First time ___1-2 years __3-4 years __ 5-7 __ 8-11 years __12-15 years __15+ years

√ Please indicate how many TCES Symposiums you have attended

____This is my first Symposium ____1-2 ____ 3-4 ____ 5-7 ____8-12

√ Would you be interested in serving as an Area Director or running for a TCES office in
future elections?

____Yes, contact me. ____I would like more information before answering. ____ No ______

 

Receipt of registration form will be acknowledged via e-mail. If you submit a registration
form but receive no acknowledgement, contact gevertson@austin.rr.com

Space is limited to 100 participants. Therefore, NO ON SITE REGISTRATION.

Symposium price is based on double occupancy with each participant in a private room within the
condo. If you have a preferred roommate, please indicate.

______________________________________________________________

NO REGISTRATION ACCEPTED AFTER JANUARY 6, 2010.

Please make a copy of this registration form for your records.

TCES Website: http://www.statweb.org/TCES


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