NAGC Student Registration Form

Student Registration Form
NAGC Member Number _____________ This is my first NAGC Convention I am a Presenter
First Name __________________________ Last Name _________________________________ M.I. _________
Mailing Address [home or work] ____________________________________________________________
City ____________________________________________ State ______________ Zip Code _______________
School/Organization Name ____________________________________________________________________
Professional Title ____________________________________________________________________________
Work Phone _________________________________ Home Phone ____________________________________
E-mail (primary) _____________________ home or work (secondary) _____________________ home or work
Register by
Please use a separate form for each attendee. Photocopy as needed.
Do not use this form if you are an Individual/Exhibitor/Group
Find registration forms online at www.nagc.org/2015convention
Attendee Information
Subtotal for Registration Fee $ ______________
Additional Registration Options and Payment
Do you require any special accommodations to participate (wheelchair, dietary restrictions, etc.?) YES NO
Explain ____________________________________________________________________________________
Do you wish to be excluded from exhibitor mailings? YES NO
Convention Registration (Thursday, Nov. 12, 3:00 pm - Sunday, Nov. 15, 12:00 pm)
* Membership + Convention Bundle includes your Convention registration PLUS a one-year NAGC Graduate Student
Membership. Benefits include member pricing for books and professional development, subscriptions to Teaching for High
Potential, Gifted Child Quarterly, and Compass Points. Choose three NAGC Networks as part of your membership:
Arts
Computers & Technology
Conceptual Foundations
Counseling & Guidance
Creativity
Curriculum Studies
Early Childhood
GLBTQ (Gay, Lesbian, Bisexual,
Transgender, Questioning)
Global Awareness
Middle Grades
Parent & Community
Professional Development
Research & Evaluation
Special Populations
Special Schools/Programs
STEM (Science, Technology,
Engineering & Math)
In order to register as a Student, include your class schedule when registering.
Register online at www.nagc.org
Mail (accepted until Oct. 30)
1331 H Street, NW Suite 1001
Washington, DC 20005
You must include a copy of your class schedule when registering.
Registration MUST be
postmarked by the
deadline noted
Early Bird Registration
(April 15 - September 21)
Advance Registration
(September 22 - October 30)
Onsite Registration
(October 31 - November 15)
$299
$358
$400
$349
$408
$425
$379
$438
$455
NAGC Member
Nonmember
**
Membership +
Convention Bundle
*
Best
Value
For Your Convention Name Badge (if you are not aliated with a company or school, include your home city and state)
First Name or Nickname as it should appear on your badge ______________________________________________________
Company or School Name _______________________________________________________________________________
City __________________________________________________________________ State _________________________
** No membership included
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NAGC Student Registration Form PDF

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