Arkansas ACDA Summer Convention Online Registration Form

Complete the information below and click the Submit button (one time only please) when finished. Fields marked with an asterisk are required. Fees should be mailed to Thomas Rickman, 17 4th Street, Greenbrier, AR 72058. Make checks payable to Arkansas ACDA. Purchase orders or credit cards are not accepted. Please note that your registration is NOT COMPLETE until your fees are received. Your receipt will be included with your badge at the clinic. If you have any questions about registration please contact Thomas Rickman at rickmant@brier.k12.ar.us.

Pre-Registration deadline is July 6th

Personal Information

*First Name: *Last Name:
*Mailing Address: *City: *State: *Zip:
*Email:
Telephone:
( )   -
School, College, or Church Name:
Place an "X" in the box beside all that apply
Elementary Junior High Senior High College
Community Choir Professional Choir Church Choir

Fees

Non-Member - Pre-Registration - $95.00, On-Site Registration - $115.00

ACDA Member - Pre-Registration - $75.00, On-Site Registration - $95.00

ACDA Membership Number:
NOTE: If you do not have your ACDA membership card, your membership number is printed on the mailing label of your Choral Journal. Look for a 5 digit number followed by the letters "ACDA" and the expiration date of your membership.

Student Pre-Registration - $10.00

Golf Tournament - $45.00

TOTALS

*Clinic Registration $
Golf Tournament $
*Total Fees Due $
Fees should be mailed to Thomas Rickman, 17 4th Street, Greenbrier, AR 72058. Make Checks payable to Arkansas ACDA. Purchase orders or Credit Cards are not accepted. Registration is NOT COMPLETE until fees have been received.
Verify Authentication Code: 
When all required data has been entered please click the button below ONE TIME. Do not double click it.