Registration Form - Tennessee Mathematics Teacher's Association

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					                           Registration Form for TMTA and UETCTM Joint Conference
                                              September 23-24, 2011
                                          East Tennessee State University

 Registration Fees include a ticket for the Friday evening banquet, continental breakfast/snacks Saturday morning, lunch
    Saturday, access to sessions, and membership to TMTA and your regional affiliate. Tickets for the Friday evening
  banquet are included in the registration fee, but additional tickets may be purchased for $15. Seating at the banquet is
                            limited and tickets will be issued on a first come, first served basis.

       The following reduced rates are available for those who pay and have their registration postmarked by
                                        September 9, 2011. No exceptions!

                                    Please complete the following carefully. Please print legibly.
                          One registration is required for each participant. Duplicate this form as necessary.

Name ______________________________________________________________home phone (_____)________________________

Email address**______________________________________________________work phone (_____)________________________

Home address____________________________________________City, State, Zip________________________________________

School Name_____________________________________________ Circle one: elementary                     middle    high    college   supervisor

School address____________________________________________City, State, Zip_______________________________________

Which address do you prefer for mailings? Home________ or School ________

Do you wish to join an affiliate leadership team? ___________ Would you like to make a presentation next year? _______________

**A confirmation email will be sent to you within 2 weeks of receipt of your registration.

                                                        Please see
                                    for conference program and websites of the affiliate organizations.
     Teacher Early Registration Fees                      Pre-Service Teacher                   Registration fee for those not paid and
Postmarked by Sept. 9—NO exceptions!                    Early Registration Fees                postmarked by September 9 or for those
  Use third column if postmarked after                 Indicate college attending:                who register on-site. Please indicate
               September 9.                      ________________________________               your affiliate choice in the first column.
Registration                          $75.00   Registration                          $45.00    Registration                          $85.00
(includes 1 Banquet                            (includes 1 Banquet                             (includes 1 Banquet
Ticket)                                        Ticket)                                         Ticket)
Additional Banquet          ______ x $15.00    Additional Banquet          ______ x $15.00     Check or PO#
Ticket(s) $15 each                             Ticket(s) $15 each
Indicate the affiliate of your choice. See     Indicate the affiliate of your choice. See            Registration forms must be
back for descriptions.                         back for descriptions.                             accompanied with payment. Make
UETCTM                                         UETCTM                                                 checks payable to TMTA.
TMATYC                                         TMATYC
(MT)2                                          (MT)2                                                    Registration questions?
MT2nw                                          MT2nw                                                 Email or call
CAMTA                                          CAMTA                                                731.881.7356 or 731.881.7477.
MAC-O-TOM                                      MAC-O-TOM                                        Contact Stephanie Kolitsch for questions
SM2EA                                          SM2EA                                                 regarding one day attendance.
TAMTE                                          TAMTE
Check or PO #                                  Check or PO #                                   Conference questions?
                                                                                               or call 731.881.7477.
                Early registration MUST be postmarked by September 9, 2011. Make checks payable to TMTA.
                 Send to: Stephanie Kolitsch, c/o UT Martin Math & Stats, 424 Humanities, Martin, TN 38238.
                      Registration questions? Email or call 731.881.7477 or 731.881.7356.
Tennessee Mathematics Teachers’ Association is supported by eight regional affiliate organizations:

CAMTA              Chattanooga Area Mathematics Teachers’ Association

MAC-O-TOM          Memphis Area Council of Teachers of Mathematics

(MT)2              Middle Tennessee Mathematics Teachers

MT2nw              Mathematics Teachers of Tennessee Northwest

SM2EA              Smokey Mountain Mathematics Educators Association

TMATYC             Tennessee Mathematics Association of Two-Year Colleges

UETCTM             Upper East Tennessee Council of Teachers of Mathematics

TAMTE              Tennessee Association of Mathematics Teacher Educators

                                    Our parent organization is the

                             National Council of Teachers of Mathematics

                                   TMTA website:

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