New England Basecamp: OpenSciEd Events Registration
How did you hear about this OpenSciEd Event?
*
At the NE Basecamp website www.nebasecamp.org
From social media (e.g., X, Facebook, LinkedIn, Instagram)
From an NEB staff member
From a supervisor or colleague at my school site
From an email, flyer or postcard advertisement
From the OpenSciEd website
From RIDE commissioner memo
From Carolyn Higgins STEM update
Other
I am registering (if registering a group the includes participants for both of our endorsement courses, please complete a group registration per endorsement course)
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Myself
A group of educators from my school or district
Which OpenSciEd session are you registering for?
Elementary OpenSciEd Sampler Session
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Individual Registration : Contact Information
Participant First Name
*
Please use the name you would like printed on end of course certification documents.
Participant Last Name
*
Please use the name you would like printed on end of course certification documents.
Phone
*
Enter your preferred phone number for receiving course-related calls. Format: (XXX) XXX-XXXX
Email
*
Enter your preferred email for all course related correspondence. This can be a personal or professional email.
District
*
Please Select
Barrington
Bristol Warren
Burrillville
Central Falls
Chariho
Coventry
Cranston
Cumberland
East Greenwich
East Providence
Exeter-West Greenwich
Foster
Glocester
Jamestown
Johnston
Lincoln
Little Compton
Middletown
Narragansett
Newport
New Shoreham
North Kingstown
North Providence
North Smithfield
Pawtucket
Portsmouth
Providence
Scituate
Smithfield
South Kingstown
Tiverton
Warwick
Westerly
West Warick
Woonsocket
Davies Career and Technical High School
Department of Children Youth and Families
Metropolitan Regional Career and Technical Center
RI School for the Deaf
Urban Collaborative
Charter School/Other
If you selected "Charter School" or "Other" for district, please indicate the name below
School
*
If you work across multiple school settings (e.g., OT, SLP) please write in the name of your primary setting/school. If you work in a district-level position or outside of a K-12 school building please enter N/A
Position
*
Please Select
Classroom Teacher
Special Education Teacher
Academic Coach/Interventionist/Specialist (e.g. math or reading specialist/coach)
Paraprofessional
School Level Administrator
Student Support Professional (e.g., psychologist, counselor, SPED coordinator)
District-level Professional or Administrator
Support Staff (e.g., OT, SLP)
Other
If you selected "Other" for position, please indicate your position below
Accommodations Request:If you would like to make NEB facilitators aware of any accommodations, such as assistive technologies, that benefit you and your learning, please let us know here.
How will you be paying for this course?
Please Select
Myself (invoice will be sent to your email)
School/District Sponsored (Non-RI educator/resident, Invoice will be sent via email to the contact provided for invoicing)
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Group Registration : Contact Information
Your Full Name
*
Name of person responsible for registering the group
Phone
*
To contact for group registration questions, Format: (555) 555-5555
Email
*
Email to contact for group registration questions
District
*
Please Select
Barrington
Bristol Warren
Burrillville
Central Falls
Chariho
Coventry
Cranston
Cumberland
East Greenwich
East Providence
Exeter-West Greenwich
Foster
Glocester
Jamestown
Johnston
Lincoln
Little Compton
Middletown
Narragansett
Newport
New Shoreham
North Kingstown
North Providence
North Smithfield
Pawtucket
Portsmouth
Providence
Scituate
Smithfield
South Kingstown
Tiverton
Warwick
Westerly
West Warick
Woonsocket
Davies Career and Technical High School
Department of Children Youth and Families
Metropolitan Regional Career and Technical Center
RI School for the Deaf
Urban Collaborative
Charter School/Other
If you selected "Charter School" or "Other" please type it below
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Invoicing Information
If you are paying for the course yourself please enter your information below, if your School/District is sponsoring your participation please ensure that you have the correct information for the School/District to be invoiced.
Invoice School/District Name
*
Name of school/district to address the invoice, if paying yourself please write N/A
First Name (for invoicing)
*
Name of person to address the invoice to
Last Name (for invoicing)
*
Name of person to address the invoice to
Invoice Email
*
Email to send invoices to
PO number if applicable
Invoicing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Group Registration: Participant Information
Please ensure that you register each participant by clicking "+Add Row" for additional spaces.
Group Registration
*
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Course Requirement Acknowledgements
Email
example@example.com
Please read and check to affirm the following statements.
*
My Products
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( X )
Taste of OpenSciEd-
RI Educator/Resident
Free
$
Free
Assessment in OpenSciEd-
RI Educator/Resident
Free
$
Free
Taste of OpenSciEd-
Non RI Educator/Resident
$50.00
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Assessment in OpenSciEd-
Non RI Educator/Resident
$50.00
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Elementary OpenSciEd Sampler Session
RI Resident/Educator
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Elementary OpenSciEd Sampler Session
Non RI Educator/Resident
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
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