2019 AMTNJ Winter Conference Online Registration Form

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The Association of Mathematics Teachers of New Jersey
presents our

Annual Winter Conference
"Mathematical Sense Making for All Students"

Keynote Speaker

Dr. Keith Devlin
Stanford Professor, Author of Devlin's Angle, and The Math Guy on NPR

The Ramada Plaza Conference Center
390 Forsgate Road
Monroe Township, NJ

Please note: AMTNJ reserves the right to limit registration according to the fire codes set by the hotel's limitations.

Please note: AMTNJ does not accept cancellations after one week prior to any conference.

Please submit your registration to your Board of Education as early as possible for Board approval.

PLEASE VISIT OUR EXHIBITORS

If you would prefer to submit by mail, email or FAX, please print a pdf copy of this form from our website (www.amtnj.org) and send to:

AMTNJ
PO Box 264
Bay Head, NJ 07624

Email: amtnj@juno.com

FAX: 732-399-5388

Questions: Please call 732-788-1257

Email *

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Last Name *

First Name *

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Home Street Address *

Home City *

Home State (please use two letter abbreviation - e.g., NJ) *

Home Zip Code *

Home Phone (please use XXX-XXX-XXXX format)

Cell Phone (please use XXX-XXX-XXXX format) *

Home Email address *

Home FAX number (please use XXX-XXX-XXXX) format

School Name *

School District *

School Street Address *

School City Name *

School County *

School State (please use two letter abbreviation - e.g., NJ) *

School Zip Code *

School Phone (please use XXX-XXX-XXXX format) *

Please Check Primary Position *

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Coach

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Other:

Grade Level(s) taught - please check all that apply *

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Preferred AMTNJ Mailing Address *

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Previous Member *

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Other:

Are you willing to have your picture taken for publicity purposes for AMTNJ? *

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Other:

Interested in Volunteering? *

Yes

Other:

Interested in Speaking? *

Yes

Other:

Interested in donating to the AMTNJ Scholarship Fund? If so, please indicate amount. (A tax deductible receipt will be provided, if requested.)

Select Registration Option *

Member - $149.00

Non-member - $164.00 (Please note: Non-member fees include an eMembership for 2018)

Non-member - $179.00 (Please note: Non-member fees include a full Membership for 2018)

Please Select Payment Option *

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PayPal (please go to http://amtnj.org/make-a-payment/) to make payment after submitting your registration form

Purchase Order

Other:

If Payment is via a Purchase Order, please enter the number below (if it is known)

A copy of your responses will be emailed to the address you provided.

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