Foundational Training
Registration Form and Online Payment


Part 1 - Contact Information

We understand that actual team participants may not be finalized; however, please provide as much information as possible to aid us in workshop preparation.

*  Workshop/Date:

Team Contact Person

*  First Name:
*  Last Name:
*  Email Address:
*  Work Phone:
*  Other Phone:
    Home Address:
*  School Name:
    School Principal:
    Principal Email:
*  School District:
Has your school participated in Level I professional development before?
Yes
No


Part 2 - Team Members

Final team must include a minimum of 3 people including an arts specialist, classroom teacher, and administrator. The team can include up to 10 people. Please submit additional names by email.

Arts Specialist Representative

First Name:
Last Name:
Position:
Email Address:
Has team member participated in Level I professional development before?
Yes
No


Classroom Teacher Representative

First Name:
Last Name:
Position:
Email Address:
Has team member participated in Level I professional development before?
Yes
No


Administration Representative (seat can be shared throughout the 2.5 days)

First Name:
Last Name:
Position:
Email Address:
Has team member participated in Level I professional development before?
Yes
No
Please provide any dietary restrictions or special needs of team members:


Part 3 - Online Payment

Full Name:
Credit Card Number:
Credit Card Type:
Exp Date:
Code:

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