Techniques October 2012 - Cover3

REGISTRATION FORM • THIS FORM IS VALID THROUGH 10/29/12
CareerTech VISION 2012—An International Summit on Excellence in CareerTech Education Atlanta, Georgia • Nov. 28–Dec. 1, 2012 • www.careertechvision.com

STEP 1: PERSONAL INFORMATION
ACTE Member (Membership must be active with National ACTE at time of registration) Member ID # ___________________ Non-member—visit www.acteonline.org/join.aspx to save up to $180! I am a first-time ACTE annual event attendee Yes Mr. Mrs. Ms. Dr. (Please print clearly) SS# (last four digits)1 _____________________________________________ First Name _____________________________________________________ Last Name/Surname ______________________________________________ Preferred Name for Badge __________________________________________ Name of Spouse (if registering) ______________________________________ Name of Business/School __________________________________________ Address
(The address listed above will be encoded on your SmartCard and is the address to where your VISION materials will be mailed. This will not update your membership address.)

STEP 2: DEMOGRAPHICS
Check one option in each section. A. Field of Specialization

Speakers must fill out the Speaker Registration Form

B. Position Title

Administration Agricultural Education Business Education Engineering and Technology Education Family and Consumer Sciences Education Guidance and Career Development Health Science Education Marketing Education Postsecondary, Adult and Career Education Special Populations Trade and Industrial Education *New and Related Services *If you selected the New and Related Services Division
as a primary or additional Division, please select one section within that Division below.

Teacher Subject: _________________________ Teacher Educator Teacher Supervisor Student Administrator/Supervisor Counselor Business/Industry Representative Other: _________________________ Comprehensive School Secondary Vocational/Technical School Junior High School/Middle School Two-year Postsecondary School Local School System Federal, State or LEA Four-year College or University Business Other: _________________________ Decision-maker Consult None

C. Type of Institution

Business/School

Home

Address _______________________________________________________ City _____________________________ State ________ ZIP _____________ Phone ___________________________ Fax ___________________________ E-mail (required) ________________________________________________
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Career Academy Cooperative Work Experience Information Technology Instructional Materials Integration of Academics and Career and Technical Education International Makers of Policy

Professional Development Public Information Research ROTC Safe Schools School-to-Work/Careers Support Staff Teacher Educators Tech Prep Other

D. Purchasing Power

STEP 3: REGISTRATION OPTIONS AND RATES
For student and retired member rates, call 800-826-9972.
FEES INCLUDE ALL EDUCATION SESSIONS ADVANCE POST-ADVANCE TOTAL 7/14–10/29 AFTER 10/29

STEP 4: HOW TO REGISTER
Registrations will not be accepted without payment. To qualify for the early-bird ONLINE at www.careertechvision.com (PREFERRED METHOD) CREDIT CARD (VISA, MC, AMEX AND DISCOVER ACCEPTED) DO NOT FAX MAIL CHECK (ALLOW 2–3 WEEKS FOR PROCESSING)
• Payable to ACTE (in U.S .dollars and drawn on a U.S. bank) • Copy of registration form must accompany the check payment • Copies of checks will NOT be accepted. DO NOT FAX

or advance rate, ACTE must receive your registration, along with method of payment (including purchase orders), by the deadline (no postmarks). Otherwise, the next applicable rate will apply.

CareerTech VISION 2012 and CareerTech Expo3 (NOV. 29–DEC. 1)
FEES INCLUDE A SODA BREAK ON THURSDAY AND BOX LUNCH ON FRIDAY IN THE EXHIBIT HALL.

ACTE Member4 Non-member

$445 $625

$525 $695

_________ _________

Remit to: P.O. Box 758621, Baltimore, MD 21275-8621

One-day VISION 2012 (PLEASE CHECK DAY) Thursday (INCLUDES EXPO) Friday (INCLUDES EXPO) ACTE Member Only4 Non-member ACTE Member4 and ACTER Sessions Non-member and ACTER Sessions ACTER Sessions Only ACTER Membership Dues Other Spouse (CANNOT BE ACTE MEMBER.
INCLUDES CAREERTECH EXPO LUNCH)

$275 $365 $585 $765 $150 $40

$325 $445 $695 $865 $180 $40

_________ _________ _________ _________ _________ _________

FAX

PURCHASE ORDER (ALLOW 5-7 BUSINESS DAYS FOR PROCESSING)
• Fax to 703-683-9367 • ACTE requires the following in order to avoid delay in processing: • Copy of the PO must accompany the completed registration form • PO must include the following: • Your PO must have your organization’s full contact information • The financial agent’s printed name, signature, e-mail address and • • • •

ACTE and/or ACTER-OTT-Academy Conference

phone number, and complete bill-to and ship-to addresses ACTE’s contact information Complete registration description with correct price and registrant’s name The PO date, PO number and payment terms Initial and date any handwritten or overtyped amendments to the PO

QUESTIONS? Call 800-826-9972 $210 $50 $220 $50 _________ _________

Awards Banquet
(WEDNESDAY 7:00 P.M.–9:00 P.M.)

Total Registration Amount Due $__________
NOTES 10 percent Group Discount: When you register 10 or more individuals from the same institution and pay with one check or purchase order, you can receive a 10 percent group discount. Registration forms must be received with the payment. Each attendee must fill out a registration form. Substitutions: Substitutions will not be accepted unless received in writing from the original registrant by 11/8/2012. Registrants unable to attend may send a substitute. A letter from the original registrant authorizing the substitution must be e-mailed to registration@acteonline. org or faxed to 703-683-9367, along with the substitute’s completed registration form, by 11/8/2012. The substitute’s registration fee will be subject to pricing based on her/his ACTE membership status. Cancellations: A $100 cancellation fee will be charged for all VISION 2012 pre-registration refunds requested in writing by 11/8/2012. Requests for refunds must be submitted in writing to registration@ acteonline.org or faxed to 703-683-9367. No refunds will be issued after this date. Badge credentials must be returned with refund request.

After 11/8/2012, registrations and payments will only be accepted in Atlanta, Georgia.
V12TECH
unique identifier for members. At no time would ACTE make this information available to third parties. E-mail Address: Confirmations may be sent by e-mail. Please provide a valid e-mail address. Includes all open ACTE and NAAE programming. Membership must be active with ACTE at the time of registration. Registration categories will be confirmed before registration is processed. POs will not be accepted for membership. ACTE member rate is extended to NAAE members who are also ACTE members. By registering, you grant permission for the use of your name, voice and/or likeness related to your participation in any event affiliated with CareerTech VISION 2012 and the CareerTech Expo. You waive all rights to any compensation and to approve the images, audio and/or printed and electronic material in which they are used, and you release ACTE and its employees and agents from any claims, damages or liability.
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Privacy Statement: You are not obligated to provide this information; however, ACTE uses this information internally as a

Techniques October 2012

Table of Contents for the Digital Edition of Techniques October 2012