EmailMeForm
2018 Professional Development Workshop
with Henry Leck and Darren Dailey
Teacher Registration Form
Name
*
First
Last
School or Church / Religious Affiliation
*
County
*
Check one:
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Public School
Private School
Church / Religious Institution
Grades Taught
*
Mailing Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Cell Phone
*
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Cell Phone Carrier
Alternate Phone
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Email Address
*
Communication is primarily through email.
MASTER CLASS PARTICIPANTS will get 10 minutes of podium time to conduct for Mr. Leck and have a private coaching session with Mr. Dailey. Master Class is limited to 18 conducting participants.
OBSERVERS will participate in all workshop activities, but will not conduct for Mr. Leck. You may choose a 1 day or 3 day option.
Register by Jan. 31, 2018 and save 10%!
I will attend ALL THREE DAYS (Friday, Saturday, & Sunday) as a MASTER CLASS PARTICIPANT. ($230)
I will attend the 3-Day Workshop as an OBSERVER ONLY - Friday, Saturday, and Sunday ($210)
I will attend the Friday Workshop ONLY as an OBSERVER ($87)
I will attend the Saturday Workshop ONLY as an OBSERVER ($87)
Will you be able to participant in the Sunday Morning Worship Service at Southside United Methodist Church?
Please select
Yes
No
Unsure
What do you hope to gain from this workshop?