Mail In Registration

Mail In Registration

To pay by check, Please submit the form below.
Then, send a printed copy of the registration form and your check to:

Susan Oleson, WCSLA
21594 Birchwood
Farmington, MI 48336

Your payment MUST arrive by the deadline date.

NOTE!! If you are mailing in a check, you STILL NEED TO FILL OUT A REGISTRATION FORM ONLINE AND SUBMIT IT. ONLINE FORMS SHOULD BE FILLED OUT BY THE REGISTRANT TO MAKE SURE ALL INFORMATION IS COMPLETE. You must also print off the form and mail it in with a personal check or have the district mail the form in with the school district's check. If you are paying for MORE than one participant, the form MUST BE submitted for EACH participant attending.

Name:
Address:
City, State, Zip
Phone:
Email Address:
Early Bird Registration (all three workshops and your membership fee is waived) Deadline - October 1, 2010	$120
Workshop #1 - October 8, 2010 Deadline - October 1, 2010	Member $40 Non - Member $50
Workshop #2 - December 3, 2010 Deadline - November 25, 2010	Member $40 Non-Member $50
Workshop #3 - May 4, 2011 Deadline - April 28, 2011	Member $40 Non-Member $50
Yearly Membership Dues	$20
CEU's $10 fee per workshop	CEU's are available for purchase at the workshops.
	Total Amount Due: $