*  First Name: *  Last Name: *  Email Address: *  Work Phone: Address: City: State: --United States-- Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming --Canada-- Alberta British Columbia Manitoba New Brunswick Newfoundland North West Territory Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Not Applicable Zip Code: CTA Chapter Check the box if you are a member of a school team School Name *  District or Organization Position I am attending the August 29th session only I am attending the August 30th session only I am attending both sessions *  Enter the letters shown above:

* - required