Curriculum & Assessment Workshops registration

Student Engagement Equals Student Achievement
Date: March 21, 2012
Time: 10:00-3:00
Members Fee: $150
Non-Members Fee: $250
Fee Includes Lunch and Materials
Facilitator: Staff Member
Location: SuccessLink Office

To register for the workshop simply fill out and submit this form. For additional information regarding the next workshop please contact SuccessLink by calling 1-888-636-4395

First Name:*

Last Name:*

Grade Level Taught: Select One
Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade 9th Grade 10th Grade 11th Grade 12th Grade Administrator

School District:*

School Building:*

Billing Address:*

City:*

State:*

Zipcode:*

School Phone Number:

E-mail Address:*

Payment Method:*    Check Credit Card
(If paying by credit card please call SuccessLink at 1-888-636-4395 with your credit card number ready)

P.O. Number:*
(All registrations must be submitted with a pre-approved purchase order number to be accepted)

Workshop Fee:

Cancellation Policy: The workshop registration is non-refundable; in the event you are unable to attend you may send a replacement. If you are sending a replacement please contact SuccessLink at 1-888-636-4395 to give the name of your replacement no later than March 11, 2012.

In case of inclement weather please contact our office for workshop updates at 888-636-4395.