Workshop Registration

Workshop Name(Required)

Primary Contact Details

Name(Required)

First Last

Email(Required)

Phone(Required)

Your Role(Required)

School(Required)

School City / State(Required)

Participant Details

Number of Participants(Required)

Please enter a number from 1 to 5.

Check this box if the primary contact is also a workshop participant

Yes, I am also a participant (use my same info)

Participant 1 Info(Required)

Full Name

Phone

Role

Participant 2 Info(Required)

Full Name

Phone

Role

Participant 3 Info(Required)

Full Name

Phone

Role

Participant 4 Info(Required)

Full Name

Phone

Role

Participant 5 Info(Required)

Full Name

Phone

Role

Payment Info

How will you be paying?(Required)

Total Registration Fee(Required)

Price: $899.00

Credit Card(Required)

Card Details

Cardholder Name

Mailing address and instructions will be provided once you complete your registration. NOTE: Registration is NOT complete until we receive and verify payment.

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Workshop Registration

Primary Contact Details

Participant Details

Payment Info

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