Last Name: _______________________ First Name: __________________ (Title:) _________

Preferred mailing address: Home_______ School_______

Home Address: (include city, state, and zip)
____________________________________________________________________________

Home Phone #: _______________________ County in which you teach: ___________________

Preferred E-mail Address: ____________________________________________________________________________

School Name: _________________________________________________________________

School Address: (include city, state, and zip) ____________________________________________________________________________

School Phone #: ____________________________ School Fax #:________________________

Level(s) you teach or supervise - circle all that apply: K, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, C

Professional organizations to which you belong: AMTNYS___ NCTM ___ NYSAMS___ Other
____________________________________________________________________________

If you are in your last year of college, please leave an address to which mail can be sent in 2008:
____________________________________________________________________________

Registration Rates (includes a $5 membership Fee)

Pre-Registration:	On-Site Registration:
—Teacher $35	—Teacher $45
—Student $20	—Student $45
Membership Only $5

Make Checks Payable to:
Treasurer, TCMEA

Mail Registration and Check to:
Suzanne Libfeld
2843 Old Yorktown Road
Yorktown Heights, NY 10598