Please fill out the following
registration form to register. Don't leave any
blanks empty. |
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Conference Information: |
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Place all course numbers you plan to take in the blank
These are summer courses onsite or face to face for Summer
2024 |
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Registrant Information: |
Name: |
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Street Address: |
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Use your home address - not school address |
City: |
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State: |
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Zip: |
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Have you ever taken
one of our courses before? |
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Respond with either: Returnee or First Timer
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Cell Phone |
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Please format as: 555-555-5555 |
Indicate The Site
You Plan To Attend: |
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Place Sandusky, Cincinnati |
Personal Email
Address- Not School Email Address: |
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This is required for confirmation |
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School & Professional
Information About Your Position |
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Will you have others
from your district attending the class? |
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Yes or No |
Are you taking
the workshop for license renewal, salary increment,
or PD? |
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Answer "License Renewal, Salary Increment. or PD |
Name Of Your School |
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Identify the name of your school |
Street Address |
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List the street address of your school |
City, State, and
Zip Code |
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City, State, and Zip Code for your school address |
Your School Email
address |
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Provide your school email address |
Your Position |
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Teacher - Counselor - Administrator |
Grade Level |
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List the grade level(s) of students you serve |
Subject Area |
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List the subject area(s) you teach |
Type of School |
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Elementary, Middle, or High School |
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Credit
Cards are not accepted. |
No payment is due now.
Deposit is due on Day 1 of Class. The remaining
balance is due on Day 3 of class |
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Credit Cards Are Not Accepted |
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Deposit Due On Day 1 & Remaining balance Due on Day
3 |
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$ 225 Remaining Balance Paid To: |
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Oakland City University on Day 3 of Class |
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138 N. Lucretia Street |
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Oakland City, Indiana |
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When information is complete, click on Register. |
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