Membership and Conference Online Registration via PayPal

Professional Information: Level *

(Choose One)

Elementary School

Middle School

High School

University Faculty

Student

Other

Professional Information: Field *

(Choose One)

Athletics

Health

Physical Education

Recreation

Dance

Adapted Physical Education

Early Childhood

Other

Professional Information: Position *

(Choose One)

Teacher

Coach

Athletic Trainer

Administrator

Student

Other

MEMBERSHIP FEES *

Professional Member: $25.00

Three Year Professional Member: $60.00

Student Member (Full time Undergraduate/Full time Graduate): $10.00

Retired Professional Member: $ 0.00

CONFERENCE REGISTRATION

(In order to attend the convention, you must have current Shape Delaware membership)

NO REFUNDS WILL BE ISSUED

Professional Members

Back to School Special Fee (received prior to 10/01/2019 at 11 pm $25.00

Member Fee (after 10/01/2019) $30.00

Member On-Site Fee $35.00

Non-Member Fee $75.00

Retired Professional Fee $15.00

Student Members

Back-to-School Special Fee (received prior to 10/01/2019 at 11 pm) $10.00

Student Member Fee (after 10/01/2019) $15.00

Student Non-Member Fee $25.00

Back to School Special Registration MUST be received PRIOR to 10/01/2019 at 11 pm to be eligible for boxed lunch.

Payment

Complete this form and Click SUBMIT to pay ONLINE via PayPal.

Please be patient once you click on the submit button. Please do not click multiple times.

Questions? Please email: president@shapedelaware.org

Membership and Conference Online Registration via PayPal

NO REFUNDS WILL BE ISSUED

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