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2022 NC SHAPE Convention

Professional Non-Member $175.00

Early bird registration for non-members

For the best results, please respond to all registration items. You may respond "NA" to any items that are not applicable to you.

First Name

Last name

Preferred First & Last Name (for name badge)

Phone Number

Email Address

School System

Preferred Name of School/Company/Organization (for name badge)

Job Title / Position

Are you a professional or a student?

Professional Student

Who influenced or recruited you to attend the convention?
Please provide the person's first and last name.

Are you an invited or featured presenter? Formal invitations to present or speak are extended by board members.
If you received a formal invitation from a board member, please share the name of the person who extended the formal invitation.

If you are an invited or featured speaker, please enter the code you were given by the person who invited you.

	Yes	No
Are you a member of NC SHAPE?
Is this your first NC SHAPE Convention?

Associated Professional Member Registration is for SHAPE America & sister state SHAPE/AHPERD members.

Those registering as Associated Professional Members must email a screenshot or other proof of your membership in SHAPE America or a sister state SHAPE/AHPERD to donna@ncshape.org immediately after registering as an Associated Professional Member.

	Yes	No
Are you registering as an Associated Professional Member?
Are you a member of SHAPE America?

If you are a member of a state SHAPE or state AHPERD other than North Carolina, select that state from this list.

Comments:

Office use only:

Search NCAAHPERD-SM

Artie Kamiya, Executive Director

Cell: (919) 818-6486

Address: 3509 Mossdale Avenue, Durham, NC 27707
Email:

Affiliates & Partners

The Alliance partners with other organizations that have common goals and interests. We encourage you to support their work as well as ours as together we strive to create a healthier, more creative, and active North Carolina.

NCAAHPERD-SM is a 501(C)(3) not for profit organization of athletics, health, physical education, recreation, and dance professionals whose mission is "To provide advocacy, professional development, and unity for health, physical education, recreation, dance, and athletics professionals and students in order to enhance and promote the health of North Carolinians. Our vision is to be the leading organization promoting and supporting a healthier, more creative, and active North Carolina."