11th Annual National Conference of

The National Association for Alternative Certification

April 17 - 20, 2001

Revisting the Past -- Exploring the Future

Registration Form

Please print this form then fill it out and return it with your registration fee.

 Please direct questions regarding registration for the conference to Bob Schreiner, bosch@esc4.net

Name:___________________________________________

Institution:_______________________________________

Mailing Address:_________________________________________

City_________

State:___________

Zip:_________

Work Telephone:__________________________________

E-Mail Address:___________________________________

Registration Fees		Amount Included
	$200 Regular	_________
	$125 Interns	_________
	$250 Late Registration	_________
Options
Wednesday Evening
Guests for Luau	$35 per person	_________
Thursday Evening
Mexico - time to shop and eat - transportation only	$15 per person	_________
meal additional
--OR--
Texas Ranch Bar-B-Q Cruise - includes BBQ meal (limit 75 person per boat)	$30 per person	_________
TOTAL (Checks Only)		_________

Make checks payable to the host state organization:

(TAX ID# 1-76-0549122-8)

TACA (Texas Alternative Certification Association)

C/O Bob Schreiner, Treasurer

18207 Cobblestone Drive

Cypress TX, 77429