The Unspoken Truths & PSESD Training Registration Form
Professional Development and Round Tables
Registration Type
*
Individual: $300-$500 per person
Group: $275-$475 per person for groups of 5 or more
Preferred Training Session(s): Please suggest dates/times and we will confirm based on availability. Max capacity is 25 participants per session. Invoicing details will be gathered at the time of confirmation.
Your Name
*
First Name
Last Name
Title / Position
*
School District / Organization
*
School Name
*
Grade level(s) that you teach if in classroom(s)
*
How do you identify ethnically?
*
Please Select
American Indian or Alaska Native
Asian
Black / African-American
Black / African
Native Hawaiian or Other Pacific Islander
White
Other (Please specify in "Additional Comments" below)
Additional Comments
Phone Number FOR FOLLOW UP REGARDING THIS REGISTRATION
Please enter a valid phone number.
Email FOR FOLLOW UP REGARDING THIS REGISTRATION
example@example.com
Submit Application
Should be Empty: