September 25 Joint Governance Staff Meeting - Maryland State Education Association

Name *

First

Last

Address (staff can put worksite location)

Address Line 1

Address Line 2

City

State

Zip Code

Mobile Phone (staff-provide you MSEA phone-HQ number is fine) *

Personal Email (staff-use your MSEA email) *

Local Association *

If other, specify below:

Race/Ethnicity *

Gender *

Pronouns for Name Badge *

Self Description for Name Badge

Allergies

Please indicate if you have any environmental or food allergies that we should be aware of, e.g. nuts, dairy, gluten.

Role

MSEA Board member
Local President
Local President’s designee
MSEA Staff

If you are a local president or president's designee, are you staying for the local presidents' meeting (3:30-4:30) *

Yes
No
N/A

Are you a first-time attendee? *

Yes
No

Cancellation Policy (N/A for staff)

1. Cancellations must occur at least 5 days before the event. You may cancel by phone (410-263-6600) or by emailing [email protected]. If you do not cancel prior to this date, you will forgo any payment for the event and will be assessed any costs incurred by MSEA as a result of the late cancellation. The manager responsible for the event or the MSEA president may waive costs in the case of emergency with appropriate documentation. 2. Barring an emergency reason, cancellations less than 5 days before an event or no-showing at an event will mean that any costs incurred by MSEA will be passed on to the attendee. 3. Reservations for this event are nonrefundable and nontransferable.

MSEA provides a hotel room to those who must travel a distance greater than 100 miles one way before 7 AM in order to be at the meeting by 10:00 a.m. Do you need accommodations the evening of February 19? Note: If you request accommodations and cancel after February 17, members will be responsible for any room charges incurred. *

Yes
No

Do you require release time to attend the meeting? *

Yes
No
N/A

Release time must be requested by September 10 using the following link: https://marylandeducators.wufoo.com/forms/s1n6qbp71hwjb99/ If you have any questions, please contact Lynn Tipton at [email protected].

A/V Policy

Video and sound recording is prohibited at MSEA events.

Accommodations and Special Requests

We are committed to providing an accessible event for all participants. If you require any accommodations due to a disability or have any special needs, please describe any necessary accommodations here or contact us directly to ensure that your needs may be met in this event. We will attempt to make every reasonable effort to accommodate your request.

Describe accommodations/special requests here.