REGISTRATION FORM
AASC SUMMER WORKSHOP
JULY 18-21, 2006
Registration Instructions:
1. Mail check (made to AASC) and this form to:
DANNY COLLIE
AASC WORKSHOP DIRECTOR
LAKE HAMILTON HIGH SCHOOL
280 WOLF DRIVE
PEARCY, AR 71964
2. Each school delegation must have an adult who will attend the workshop.
3. Registration cost postmarked prior to June 16 will be $140 per delegate for member schools and $150
for non-member schools.
4. After the postmark date of June 16, the registration fee is $160.
5. Make checks payable to AASC.
6. No registrations will be accepted after the postmark date of July 1.
7. Each school is limited to 10 student delegates.
8. T-shirts are included in the registration cost. (added cost for larger sizes)
SCHOOL INFORMATION
School_____________________________________________________________________
Phone Number_________________________________________________
Address____________________________________________________________________
City________________________________________________________________________
ZIP________________________________
ADULT INFORMATION
Name______________________________________________________________________
Gender_______________ Phone________________________________
Address____________________________________________________________________
City________________________________________________________________________
ZIP_____________________________
T-Shirt Size______ Summer Email_____________________________________
____ Yes, I am interested in working with a small group. (Training begins on Monday evening July 17at 7:00
pm.)
____ No, I am not interested in working with a small group.
Name______________________________________________________________________
Gender_______________ Phone________________________________
Address____________________________________________________________________
City________________________________________________________________________
ZIP_____________________________
T-Shirt Size______ Summer Email_____________________________________
____ Yes, I am interested in working with a small group. (Training begins on Monday evening July 17 at 7:00
pm.)
____ No, I am not interested in working with a small group.
STUDENT INFORMATION
Name_______________________________________________________________
Gender______ Phone Number________________________________________
Address_____________________________________________________________
City_________________________________________________________________
ZIP_______________________ T-Shirt Size __________
Email________________________________________________________________
Name_______________________________________________________________
Gender______ Phone Number________________________________________
Address_____________________________________________________________
City_________________________________________________________________
ZIP_______________________ T-Shirt Size __________
Email________________________________________________________________
Name_______________________________________________________________
Gender______ Phone Number________________________________________
Address_____________________________________________________________
City_________________________________________________________________
ZIP_______________________ T-Shirt Size __________
Email________________________________________________________________
Name_______________________________________________________________
Gender______ Phone Number________________________________________
Address_____________________________________________________________
City_________________________________________________________________
ZIP_______________________ T-Shirt Size __________
Email________________________________________________________________
Name_______________________________________________________________
Gender______ Phone Number________________________________________
Address_____________________________________________________________
City_________________________________________________________________
ZIP_______________________ T-Shirt Size __________
Email________________________________________________________________
Name_______________________________________________________________
Gender______ Phone Number________________________________________
Address_____________________________________________________________
City_________________________________________________________________
ZIP_______________________ T-Shirt Size __________
Email________________________________________________________________
Name_______________________________________________________________
Gender______ Phone Number________________________________________
Address_____________________________________________________________
City_________________________________________________________________
ZIP_______________________ T-Shirt Size __________
Email________________________________________________________________
Name_______________________________________________________________
Gender______ Phone Number________________________________________
Address_____________________________________________________________
City_________________________________________________________________
ZIP_______________________ T-Shirt Size __________
Email________________________________________________________________
Name_______________________________________________________________
Gender______ Phone Number________________________________________
Address_____________________________________________________________
City_________________________________________________________________
ZIP_______________________ T-Shirt Size __________
Email________________________________________________________________
Name_______________________________________________________________
Gender______ Phone Number________________________________________
Address_____________________________________________________________
City_________________________________________________________________
ZIP_______________________ T-Shirt Size __________
Email________________________________________________________________
WORKSHOP HOUSING ASSIGNMENTS
ADVISORS:
_______________________ prefers to room with _____________________
_______________________ prefers to room with _____________________
STUDENTS:
_______________________ prefers to room with _____________________
_______________________ prefers to room with _____________________
_______________________ prefers to room with _____________________
_______________________ prefers to room with _____________________
_______________________ prefers to room with _____________________
REGISTRATION FEES DUE
Make checks payable to AASC. DEADLINE:
JUNE 16
Mail to: Danny Collie
AASC Workshop Director
Lake Hamilton High School
280
Wolf Drive
Pearcy, AR 71964
IF YOU ARE WORKING ON STAFF AND MUST BRING STUDENTS WITH YOU ON MONDAY NIGHT, PLEASE
ADD $13 PER DELEGATE (ADULT INCLUDED) FOR EACH REGISTRATION FEE FOR THE EXTRA NIGHT'S STAY.
T-shirts are included in the registration fee, however, add $2 for XXL and $3 for XXXL.
_____ x $140 = __________ for total number of member school delegates (adults included)
_____ x $150 = __________ for total number of non-member school delegates (adults included)
_____ x $160 = __________ for registration sent after June 7 for total number of
delegates (adults included)
_____ x $13 = __________ for total number of delegates for Monday night (staff only
plus students brought in early)
$__________ = total amount add for larger t-shirt sizes
$__________ = grand total amount enclosed