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2013 Leadership Institute: Register

NASAA leadership institutes are specially designed for state arts agencies' key policy decision makers—executive directors, deputy or assistant directors, commissioners, chairs and council members. Agencies may register up to two additional staff members whose leadership development would be of particular value, for instance, staff with policy-level responsibility or emerging leaders.

Please complete all applicable fields.

Full name (as you would like it to appear on your name badge):
Title:
Agency:
Address 1:
Address 2: (optional)
City:
State / Territory:
ZIP:
Phone:    Office   Cell    Home
E-mail address:

Registration Fees

Your registration fee for the NASAA 2013 Leadership Institute includes sessions, workshops and peer group meetings along with plenty of opportunities for networking. Breakfast, lunch and coffee/snack breaks will be provided on Thursday, October 17, and Friday, October 18. Registrants also gain access to the following special events:

  • Leadership Institute Opening Reception in Teton Village, Wednesday, October 16, 6:30–8:30 p.m. (heavy hors d'oeuvres included)

  • Evening at the National Museum of Wildlife Art: reception, dinner and performances, Thursday, October 17, 7:00–9:00 p.m.

  • Business Meeting and Artist Showcase at the Center for the Arts, Friday, October 18, 4:00–6:00 p.m.

Please mark the appropriate fee:

 $350 if you are the only attendee from your agency (director, chair, council member or deputy)

 $325 if you are one of two from your agency (director, chair, council member, deputy or other)

 $300 if you are one of three or more from your agency (director, chair, council member, deputy or other)

Do you plan to bring one or more guests?   Yes     No

If yes, a guest fee of $100 per person includes admission to the following events:

  • Leadership Institute Opening Reception in Teton Village

  • Evening at the National Museum of Wildlife Art

  • Business Meeting and Artist Showcase at the Center for the Arts

Total number of guests:  

Guest name(s):

Invoicing

NASAA will invoice you or your agency. Sorry, there is no prorating of registration or guest fees. Please indicate your preference below:

 Invoice my agency for all registration and applicable guest fees.

 Invoice my agency for the registration fee, but invoice me for guest fees (if any).

 Invoice me for all fees.

Peer Group Affiliation

Please indicate the one group you plan to attend:

 Council Member or Council Chair

 Agency Executive Director

 Agency Deputy/Assistant Director

 Secretary/Commissioner/Director of Multi-Agency Department

Special Event Attendance

Please mark all events that you are planning to attend:

 Leadership Institute Opening Reception in Teton Village

 Evening at the National Museum of Wildlife Art

 Business Meeting and Artist Showcase at the Center for the Arts

Other Information

Mark only those options that apply to you:

 This is my first NASAA conference.

 I am a vegetarian.

 I have other dietary needs.
Please explain:

A staff member will contact you before September 27, 2013, to discuss arrangements.

 I need accommodations due to a disability.
Please briefly describe your needs:

A staff member will contact you before September 27, 2013, to discuss arrangements.

Administration code (leave blank unless otherwise instructed by NASAA staff):

Emergency Contact (optional)

NASAA will keep this information confidential.

Name of emergency contact:
Daytime phone number of contact:
Evening/Weekend phone number of contact:
Wyoming Arts Council THANKS! Wyoming Department of State Parks and Cultural Resources   THANKS!   WESTAF   THANKS!   National Museum of Wildlife Art   THANKS!   Dancers' Workshop   THANKS!   The William D. Weiss Donor Advised Fund of the Community Foundation of Jackson Hole   THANKS!   Bruce Richardson and Susan Stanton   THANKS!   National Endowment for the Arts THANKS!

 

NASAA's mission is to strengthen state arts agencies.
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