FSMTA Conference Registration Form

FSMTA Conference Registration Form

October 19-22 ~ Florida Southern College, 111 Lake Hollingsworth Drive, Lakeland, FL 33801
Complete a registration form for EACH person attending.
Name*

First NameLast Name
E-mail*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
MTNA # (if applicable)
FSMTA District #
Emergency Contact:
Emergency Contact Phone #:
Relationship:
First FSMTA Conference?

YesNo
New Member?

YesNo
Nationally Certified?

YesNo
State Certified?

YesNo
Student Member?

High SchoolCollege
Full Registration – Includes all workshops, Teachers Recital, Saturday Banquet, Saturday evening Concert and Reception, Sunday Master Class, and Sunday Awards Brunch. Does NOT include Friday evening Student Honors Recital and Reception, Presidents’ Luncheon, or Wellness Committee Lunch.

$225 – MTNA member after July 31, 2023$230 – Non-MTNA member after July 31, 2023$100 - Full registration for spouse of FSMTA member$0 - Free for students with Student ID (excludes Friday Recital, Banquet, and Awards Brunch)
One-day Registration - MTNA Members

$75 - Friday$75 - Saturday$40 - Sunday$0 - Free for students with Student ID (excludes Friday Recital, Banquet, and Awards Brunch)
One-day Registration - Non-MTNA Members

$100 - Friday$100 - Saturday$60 - Sunday$0 - Free for students with Student ID (excludes Friday Recital, Banquet and Awards Brunch)
Individual Tickets

$25 - Saturday Local and District Presidents' Luncheon$25 - Friday Wellness Committee Luncheon Meeting$25 - Minimum donation for Friday evening Student Honors Recital/FSMTF Fundraiser$85 - Saturday evening Banquet, MTNA members (includes artist recital and reception)$110 - Saturday evening Banquet, Non-member (includes artist recital and reception)$30 - Saturday evening Conference Artist Recital & Reception, MTNA members$45 - Saturday evening Conference Artist Recital & Reception, Non-member; (students free)$25 - Sunday morning Awards Brunch
Total amount due for Conference Registration: $*
NO REFUNDS.
Payment by:*

CheckPayPal (don't need to have a PayPal account; pay by credit or debit card)
(Make your payment at the bottom of this page using PayPal button or follow instructions for sending check.)
Menu Choices
Saturday Banquet (included with full registration): All entrees accompanied by bread and salad, dessert with tea/coffee.
Saturday Banquet - Choose one

Chicken En CrouteBlackened SalmonVegetarian Entree
Requesting gluten-free option?

Yes
Other dietary restrictions? Please note here.
Friday Local and District Presidents' Luncheon (NOT included with full registration; purchase individual ticket above)

Friday Luncheon will be a Chef Salad. Please check YES below if you need a gluten-free option:
Requesting gluten-free option?

Yes
Please make payment below.

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