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START CREATING ARTWORKS NOW!
To Bring Artworks as a donation for the Scholarship Fund / Silent Art Auction

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Please Pre-register

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Pre-Registration Form

Name___________________________________________

Address_________________________________________

City___________________State_______Zip____________

School or Program_________________________________

District_____________________County________________

Home Phone______________________________________

Work Phone_______________________________________

E-Mail Address_____________________________________

Please check the appropriate box. Make checks payable to UAEA and mail to:

KC Jones
Treasurer
kc.jones@cache.k12.ut.us
Home Phone: 435-752-7142
School Phone: 435-563-6273

KC Jones
Sky View High School
520 South 250 East
Smithfield, UT 84335

Please note: On site registration will be an additional $20

_____Active Member, $100 (includes $15.00 annual membership fee)

_____Student Member, $25 (free membership, continental breakfast, lunch, Friday banquet)

_____Banquet Guest, $12.00

_____Annual membership only, $15.00

Award Nominations - As part of this year's registration, please use the space
below to nominate an art educator for recognition for the following UAEA

____ I am interested in greater involvement in UAEA, i.e.

helping on the board, helping with conferences, presenting at workshops, etc. __________ _________ _________.