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LOUISIANA TECHNOLOGY

STUDENT'S ASSOCIATION

 

LTSA

2011

 

53th Annual Conference

 

 

March 13, 14 & 15, 2011

UNO - New Orleans, La

 

Click here for a Word Form

 

LTSA CONFERENCE REGISTRATION FORM

CHAPTER INFORMATION:

 

 

 

School Name: ____________________________________________

Address: _________________________________________________________

City: ________________________________ State: LA Zip: ________

Phone: ________________________________ Fax: ________________________

 

Conference registration fees are set and determined following an analysis of all expenditures necessary to make the LTSA State Conference a meaningful experience to all of those who attend. In total, conference registration fees must cover several different expense categories: Conference Supplies; Conference Awards; Conference Special Events; and other items.

CONFERENCE REGISTRATION FEES ARE:

Pre-Registration

Member Contestant $150.00
Guest/Alumni/Chaperone $100.00
Advisor/Teacher $150.00

(Price subject to change).

The deadline for the contestant registration fees shall be postmarked no later than February19th, 2011. THERE WILL BE NO ON-SITE REGISTRATION. However, chaperones, guest, and alumni may register on-site.

INSTRUCTIONS FOR THE TABLE BELOW:

Line 1 - indicate the total number of students and multiply by $100.00.

Line 2 - indicate the number of Advisor/Teachers and multiply by $50.00.

Line 3 - indicate the total number of Alumni/Chaperones/Guests and multiply by $50.00

Line 4 List the total amount paid. MAKE CHECKS PAYABLE TO LTSA.

1. No. Of Students Attendees

 

X $150.00

$

2. No. Of State Officers

 

X $0.00

$ 00

3. No. Of Advisors/Teachers

 

X $150.00

$

4. No. Of Alumni, Chaperones, Guests

 

X $100.00

$

5. TOTAL REGISTRATION AMOUNT

 

 

$

 

 

LTSA Conference Registration

53th Annual State Spring Conference

 

 

 

Parish: ________________________________________________________

Advisor(s): ____________________________________________________

School: ________________________________________________________

School Address: ________________________________________________

City: ________________________________LA ________________

School Phone: ________________________________________________

Advisor/Teacher ($150.00)

________________________________________

________________________________________

________________________________________

Chaperon/Guest/Alumnus ($100.00)

________________________________________

________________________________________

________________________________________

State Officer's Name & Office Held ($0.00)

________________________________________

________________________________________

________________________________________

Student Member Name ($150.00)

 

 

1. ________________________________ 2. ________________________________

3. ________________________________ 4. ________________________________

5. ________________________________ 6. ________________________________

7. ________________________________ 8. ________________________________

9. ________________________________ 10. ________________________________

11. ________________________________ 12. ________________________________

13. ________________________________ 14. ________________________________

15. ________________________________ 16. ________________________________

17. ________________________________ 18. ________________________________

19. ________________________________ 20. ________________________________

TOTALS

                                        

 

                                                                                                           

Advisor/Teacher __________ X $150.00 = __________

Chaperon/Guest/Alumnus __________ X $100.00 = __________

Student Members __________ X $150.00 = __________

State Officer __________ X $00.00 = $ 0.00

Total Number of attendees: __________ __________

                                       

 

Deadline: February 12, 2011 - Please return this form with your check made payable to LTSA to the following address:

Louisiana TSA

% Ms. Beverly R. Britton

P.O. Box 2247

Kenner, LA 70063

Phone (504) 628-7639 Cell: (504) 722-9773

Alt (985) 817-1825 Mrs. Oliva Monk

Fax (985) 536-4286

School (985) 536-4226

 

 

TEAM EVENT

LTSA Registration Form

 

Chapter Name: ________________________ Advisor(s): ____________________

EXAMPLE

Description:

Architectural Model

Code:

AM

Level:

2

Team Member Names:

1:

Jim Short

2:

Frank Tall

3:

 

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Description:

 

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LTSA SINGLE EVENT REGISTRATION FORM

Chapter Name: ____________________ Advisor(s): ______________________________

 

Participant information: For EXAMPLE 

Name:

Joe Sample

Level:

1

Event Code:

Competitive Event Description:

1:

FC

Flight Challenge

2:

GD

Graphic Design

3:

MT

Mouse Trap Car

4:

DD

Dragster Design

5:

 

 

6:

 

 

Name:

 

Level:

Event Code:

Competitive Event Description:

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LTSA ORDER FORM FOR T-SHIRTS

Conference Dates March 13, 14, & 15, 2011

Deadline to turn in this form is February 19, 2011

** We are only ordering what is needed!!

 

Name of School ______________________________

Advisor's Name ______________________________

Phone Number ______________________________

Total number of T-shirts Ordered ____________________

 

Quantity 

Number of Large T-shirts

 

Number of X-Large T-shirts

 

Number of XX-Large T-shirts

 

Number of XXX-Large T-shirts

 

 

 

PERSONAL LIABILITY AND MEDICAL RELEASE


This form is required of all children, students and adults who attend a State TSA conference. No
conference attendee is allowed to participate unless this form is received by LTSA. Parents,
chapter advisors, and state advisors: Please make a copy of this completed form for your records.
It is the responsibility of the chapter advisor to give a copy to the state advisor prior to the
conference,

Name ___________________________ Home telephone _______________
Home street address _______________ City/state/zip ____________________
Social security # ___________________ Date of birth ____________________
Advisor _________________________ State Delegation _________________
School _________________________ School telephone _________________
School street address ________________ City/state/zip ____________________

MEDICAL INFORMATION (children and students only)
1. Allergies (drug or otherwise) _______________________________________________
2. Current medication _______________________________________________________
3. Describe any history of heart condition, diabetes, asthma, epilepsy, or rheumatic fever,
Etc. _________________________________________________________________
4. Physician name _______________________ physician telephone _________________
“I hereby agree to release the Louisiana Technology Student Association, Inc its representatives,
agents, servants, and employees from liability for any injury to above named person at any time
while attending the Louisiana Technology Student Association's annual conference, including
travel to and from the conference, excepting only such injury or damage resulting from willful
acts of such representatives, agents, servants, employees.”
"I do voluntarily authorize the Louisiana Technology Student Association's state advisor,
assistants or designees for any and all claims, demands, actions, rights of action or judgments by
or on behalf of the above named person and designees for any and all claims, demands, actions,
rights or action, or judgments by or on behalf of the above named person arising from or on
account of said procedures or treatment rendered in good faith and according to accepted medical
standards.”
"I hereby authorize any physician member of the Department of Emergency Medicine of an
accredited hospital or any member of the medical staff of an accredited hospital to render
medical treatment, which is his/her judgment is deemed necessary in the care of the above named
person (child or student) while attending the Louisiana TSA annual conference, including time
traveling to and from the conference."
_________________________________ ______________
Signature of parent or guardian (if child or student) Date
___________________________ ______________
Participant or advisor's signature Date

A COPY OF THIS FORM MUST BE KEPT BY THE STATE AND CHAPTER
ADVISORS AT THE CONFERENCE AND GIVEN TO APPROPRIATE MEDICAL
AUTHORITIES IN THE EVENT OF A MEDICAL EMERGENCY.

Code of Etiquette


Conduct Practices and Procedures for the
LTSA Leadership Training Conference


Each person attending the Louisiana TSA Leadership Training Conference must read this page, complete the attached form and return it to the State Advisor as partial completion of attendance requirements. You can mail in the forms or deliver them at registration. Every attendee must have
a signed form!
1. The term "delegate" shall mean any student or adult attending the conference.
2. There shall be no defacing of public property. Any damages to any property or furnishing must be paid by the individual or chapter responsible.
3. Delegates shall keep their adult advisors informed of their activities and whereabouts at all times.
4. Delegates should be prompt and prepared for all activities.
5. Delegates should be financially prepared for all possibilities.
6. No alcoholic beverages nor narcotics in any form shall be possessed by delegates at any time, under any circumstances.
7. Delegates are required to attend all general sessions and assigned activities.
8. Identification badges will be worn at all times and must be visible.
9. The dress code must be followed at all times.
10. Advisors will be responsible for seeing that their students are on time and attend all meetings.
11. Chapter advisors will be responsible for all delegates' conduct.
12. Curfew will be enforced. (Curfew means delegates will be in their assigned room and are not allowed to leave without permission from the chapter advisor and security personnel.)
Delegates violating or ignoring any of the Conduct Rules may be sent home immediately at their own expense.
Dress Code
Delegates must adhere to the following dress code requirements while in attendance at the LTSA Leadership Training Conference:
Casual Attire
Casual pants, casual but neat blouses or shirts; skirts or dresses (appropriate in length); neat jeans (no holes, frays or sagging jeans); tennis or casual shoes; t-shirts (must be neat and in good taste). Caps/hats are NOT to be worn indoors. Swimsuits should be worn to and from the pool - not into conference rooms or the hotel lobby, gift shop, or restaurants.


LTSA STATE CONFERENCE
BEHAVIOR AGREEMENT
CHAPTER ADVISOR ADDRESS:
Ms. Beverly R. Britton
P.O. Box 2247
Kenner, LA 70063
Cell: (504) 722-9773

Alt: (985) 817-1825 Adm. Asst. Mrs. Olivia Monk
Fax (985) 536-4286 School (985) 536-4226


SCHOOL: __________________________________________________
DELEGATES NAME: _________________________________________
DELEGATE: _______________________________________________
"I have read and completely understand the State Conference Code of Behavior and Dress Code
of the Louisiana Technology Student Association."
"I do hereby agree to follow the procedure and practices described. I fully understand that this is
an education activity and will, to the best of my ability, apply myself for the purpose of learning
and uphold at all times the finest qualities of a person representing the Louisiana Technology
Student Association."
____________________________________ _________________
Participant Signature Date
PARENT/GUARDIAN - ADVISOR - PRINCIPAL:
"I approve the student named above to attend the State Conference of the Louisiana Technology
Student Association in Bunkie, Louisiana.
____________________________________ _________________
Chapter Advisor' s Signature Date
____________________________________ _________________
Parent or Legal Guardian Signature Date
____________________________________ _________________
School Principal's Signature Date

 

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