Date:  

My registration is for: Conference    Pre-Conference   Both Events

If representing an arts organization, Name of Organization:  

Name, Last:    First:  

Address 1:    Address 2:  

City   Georgia  ZIP:  

E-mail:  
[Note: your e-mail address will only be used to inform you about conference events; it will never be sold or shared with anyone for commercial purposes.]

Phone (home):     (work):  
May we contact you by phone?     Yes    No

Please make your registration check payable to: Macon Arts.

My $20 check is enclosed for the Conference.
My $5 check is enclosed for the pre-conference.

My art form:
   Visual Art (my specialization =)    
   Theater (my specialization =)    
   Music (my specialization =)    
  Dance (my specialization =)    
   Poetry/Creative Writing (my specialization =)    

I have a special interest in the following subjects or grade levels:

   Math    Science    History/Social Studies    Literature  

  K - 5th    Middle School    High School    Teacher Workshops

   Serving on a curriculum-writing team

Questions? Contact Macon Arts at 478-743-6940; info@maconarts.org