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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
== choose one ==
Not Applicable
Alamance-Burlington School System
Alexander County Schools
Alleghany County Schools
Anson County Schools
Appalachian State University Academy at Middle Fork
Asheboro City Schools
Ashe County Schools
Asheville City Schools
Avery County Schools
Beaufort County Schools
Bertie County Schools
Bladen County Schools
Brunswick County Schools
Buncombe County Schools
Burke County Schools
Cabarrus County Schools
Caldwell County Schools
Camden County Schools
Carteret County Public Schools
Caswell County Schools
Catamount School District
Catawba County Schools
Chapel Hill-Carrboro City Schools
Charlotte-Mecklenburg Schools
Chatham County Schools
Cherokee Central Elementary School District
Cherokee Central High School District
Cherokee County Schools
Clay County Schools
Cleveland County Schools
Clinton City Schools
Columbus County Schools
Craven County Schools
Cumberland County Schools
Currituck County Schools
Dare County Schools
Davidson County Schools
Davie County Schools
D.C. Virgo Preparatory Academy School District
Duplin County Schools
Durham Public Schools
East Carolina Community School District
Edenton-Chowan Schools
Edgecombe County Schools
Elizabeth City-Pasquotank Schools
Elkin City Schools
Franklin County Schools
Gaston County Schools
Gates County Schools
Graham County Schools
Granville County Schools
Greene County Schools
Guilford County Schools
Halifax County Schools
Harnett County Schools
Haywood County Schools
Henderson County Schools
Hertford County Schools
Hickory City Schools
Hoke County Schools
Hyde County Schools
Iredell-Statesville Schools
Jackson County Schools
Johnston County Schools
Jones County Schools
Kannapolis City Schools
Lee County Schools
Lenoir County Schools
Lexington City Schools
Lincoln County Schools
Macon County Schools
Madison County Schools
Martin County Schools
McDowell County Schools
Mitchell County Schools
Montgomery County Schools
Moore County Schools
Mooresville Graded School District
Moss Street Partnership School District
Mount Airy City Schools
Nash-Rocky Mount Public Schools
New Hanover County Schools
Newton-Conover City Schools
Northampton County Schools
Onslow County Schools
Orange County Schools
Pamlico County Schools
Pender County Schools
Perquimans County Schools
Person County Schools
Pitt County Schools
Polk County Schools
Public Schools of Robeson County
Randolph County Schools
Richmond County Schools
Roanoke Rapids Graded School District
Rockingham County Schools
Rowan-Salisbury Schools
Rutherford County Schools
Sampson County Schools
Scotland County Schools
Stanly County Schools
Stokes County Schools
Surry County Schools
Swain County Schools
Thomasville City Schools
Transylvania County Schools
Tyrrell County Schools
Union County Public Schools
Vance County Schools
Wake County Public School System
Warren County Schools
Washington County Schools
Watauga County Schools
Wayne County Public Schools
Weldon City Schools
Whiteville City Schools
Wilkes County Schools
Wilson County Schools
Winston-Salem/Forsyth County Schools
Yadkin County Schools
Yancey County Schools
Other
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.
== choose one ==
Not Applicable
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Comments:
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