REGISTRANT INFORMATION
First Name *
Last Name *
Name of School/Organization *
District Name *
Home Address *
City *
Province *	Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
Postal Code *
Phone *
Email *
Confirm Email *
* For confirmation, conference programming, and future notification of MYC PD opportunities.  In registering for this specialist council conference, you are voluntarily providing your personal information and consenting to its collection, use and disclosure for all purposes connected with your attendance at this conference.
REGISTRATION RATES (includes breakfast Friday and Saturday, lunch Friday, socials and MYC swag)
T-shirt Size (Adult)	Small Medium Large XL XXL
Membership Fees *  You need to become a member of the Middle Years Council to attend the conference at the rate below. *  Teachers from other provinces and territories are eligible to attend the conference at the regular rate.   *  Persons Not Eligible for Specialist Council Memberships include central office staff who did not elect active ATA membership. The Superintendent, Deputy Superintendent of school jurisdictions and teachers in charter, federal or private schools must be ATA associate members in order to qualify for specialist council membership.
Do you have a Middle Years Council Annual Membership?	Yes No
If you would like to become a member of the Middle Years Council please click here.
Conference Fees (You must select one of the fee options below)*You must choose one of the fees below in order to complete your registration
Conference rate $400  $400.00 CAD
Out-of-Province Teacher Rate $400.00 CAD
Student Registration $150.00 CAD
Presenter $150.00 CAD
Persons Not Eligible for Specialist Council Memberships                       $800.00 CAD
Executive Code:
I would like to attend the School/Facility Tour (Thursday, April 27, 2023)
Dietary Restrictions/Allergies
Please specify
Cancellations must be received prior to April 1st in order to be eligible for full refund . Cancellations received after April 1, 2023 will be granted the option to transfer fees to next year's conference or send an alternate to this year's conference.  No refunds after April 1, 2023.
For registration inquiries, please contact Chris at chris.mccullough.teacher@gmail.com  See website for conference and council information!!        http://www.ata-myc.com/
The Alberta Teachers’ Association requires the information contained on this form in order to conduct the professional and business affairs of its membership and will collect, use and disclose the personal information about you accordingly. For inquires, objections or concerns about how the Personal Information Protection Act applies to your personal information, please refer to our privacy policy on the Alberta Teachers’ Association website. Please contact the ATA at 780-447-9400 or 1-800-232-7208 and ask for the privacy officer for more inquiries about privacy concerns.