Test Rereg TAME Club Registration Form "*" indicates required fields Step 1 of 4 25% TAME CLUB: 2022-2023 ANNUAL REGISTRATIONAdult Club Sponsor - primary point of contact; supervising liaison who recruits and registers the club and students, hosts the meeting and organizes and facilitates activities during TAME Club meetings and events Adult Co-Sponsor (optional) - additional point of contact; helps with recruitment, registration, planning, activities, etc. Student Leader (optional) - may help with recruitment, planning, activities, etc. as long as an Adult Sponsor is presentCLUB TYPE: SELECT ONE OF THE FOLLOWING ONLYClub Type* Texas School Community Organization - (Scouting, 4H, Engineering service organization like NSBE Jr., IEEE, etc.) Unaffiliated - (Group of students not affiliated with any school or community organization.) Specify school type*Select onePublic SchoolPrivate SchoolCharter SchoolHome SchoolVirtual SchoolTAME Club Name* Usually the name of the school or community group, such as "Gonzalez High School" or "Girl Scout Troup 123." If your school has multiple TAME Clubs, please use names to help students tell them apart when they go to register, for example "Gonzalez HS Chemistry Club" and "Gonzalez HS Robotics Team."School District* Include the name of your school district or "none" if you are a community group.Title I School?* Yes No To be considered a Title I school, a minimum of 40% of the students must qualify for free or reduced lunch.List the name of my TAME Club on my Chapter page of the website?* Yes No Registered TAME Clubs have the choice to be listed on your Chapter page of the website to help students, parents, and local partners to know how TAME is present in a community. This listing will show the name of your school or organization. It will not show any other identifying data and is optional.Is this TAME Club new, or renewing?* New Renewing Does your club have additional adult sponsors? If so, you'll be able to register them once your Club Registration is complete.* Yes No Great! Be sure to stick around after you submit your Co-Sponsor Registration, which will allow them to log in to see the online roster, receive emails from TAME, and their own t-shirt if your club is eligible for a toolkit and funding.Additional ContactsNameSalutationEmail Add RemovePlease list adults besides Co-Sponsors you would like to be included in your TAME Club's emails about registration, toolkits, or Competition (these emails may contain private student data). Example: your school's principal or support staff in your organization.Student LeadersNameEmail Add RemovePlease list any students helping you lead the club (such as a Club President, Team Captain, Recruitment Officer, etc.) who you want to include in general emails about deadlines, competitions, scholarships, contests, etc. These emails will not include rosters or private student data. NOTE: This is not where you register students. CLUB ADDRESS/MEETING LOCATIONWhy this is important: Student Registration will show the city, then the club name, then the Club Sponsor name. We will also use it to ship out toolkits or other supplies for eligible clubs.Building* Street Address* Address 2 City* State / Province* AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code* Chapter/TEA Region*Select optionAbilene – Region 14Amarillo – Region 16Capital Area (Austin) – Region 13Corpus Christi – Region 2Dallas – Region 10East Texas – Region 7El Paso – Region 19Fort Worth – Region 11Golden Triangle (Beaumont) – Region 5Gulf Coast (Houston) – Region 4Huntsville – Region 6Lubbock – Region 17Mount Pleasant – Region 8San Angelo – Region 15San Antonio – Region 20Valley – Region 1Victoria – Region 3Waco – Region 12West Texas (Midland, Odessa, Presidio) – Region 18Wichita Falls – Region 9Mailing address (if different from meeting location - Toolkits will be shipped to this address) I understand that if my TAME Club is not at a Title 1 School, I need to recruit students so that at least 60% of student members are from TAME Focus Student groups that are underrepresented in STEM: Students who are Black/African American, Hispanic/Latinx, or Indigenous/Native American Female students My club is located in Austin, Dallas, Fort Worth, Houston, San Antonio or in a suburb of one of these cities. I will recruit students so that at least 50% of the club members meet one of the following criteria – Would be first in their family to graduate college :* Yes At a Title I school ADULT SPONSOR INFORMATIONAdult Sponsor First Name* Adult Sponsor Last Name* Preferred name for nametags How do you pronounce your name? Sponsor email* Sponsor work phone*Cell phone*Alternate email Backup in case of issues with school firewalls.Salutation*Select OneMs.Mr.Dr.Mrs.Prefer noneGender*Select oneFemaleMaleT-Shirt Size*Select oneSmallMediumLargeX-Large2XL3XL4XL5XLEthnicity:*Check all that apply. White Hispanic or Latino Black or African American American Indian or Alaska Native Asian Native Hawaiian or Pacific Islander Other Ethnicity: Other* Is this your first time sponsoring a TAME Club?* Yes No Information for events and travelFor event planning purposes (such as Divisional and State STEM Competitions):Dietary needs* Vegetarian Gluten-free Vegan None Dairy-free Other Dietary (other)*Please describe your needs. Medical Needs* Medications Medical Conditions None Medications* Medical Conditions* Accessibility Needs* Yes No Please describe your needs* Do you have an active certification in First Aid/CPR?* First Aid CPR Neither CLUB ADULT SPONSOR CERTIFICATIONPlease check to confirm that you understand and agree to the following requirements for your TAME Club:* My TAME Club will recruit at least 6 student participants. All participants in my club are in grades 6 – 12 If my TAME Club is not located at a Title I school, I will recruit students so that at least 60% of students members are from TAME focus student groups. I will coordinate regular meetings about STEM Topics for my club members (in person, virtual, or socially distanced with appropriate precautions) I will provide my students with the registration link and encourage them to register online. By signing below I affirm that all of the above statements are true and that my group is eligible to register as a TAME Club. I understand that TAME can cancel my membership at any time if it is determined that my group is ineligible. Signature* Reset signature Signature locked. Reset to sign again HiddenUsername NameThis field is for validation purposes and should be left unchanged.
