FALL 2008 ONLINE WORKSHOP REGISTRATION FORM

1. Which workshop do you wish to register for? Choose only one.

Improving Student Performance with the Collins Writing Program ~ Developing Writing and Thinking Skills Across the Curriculum (Grades 4-12)

Which date/location? Select One October 13, 2008 Brookfield, WI October 16, 2008 Sturbridge, MA October 17, 2008 Southbury, CT October 20, 2008 Portland, ME October 20, 2008 Bloomington, MN October 21, 2008 Andover, MA October 23, 2008 Columbus, OH November 17, 2008 Pittsburgh, PA November 18, 2008 Harrisburg, PA November 19, 2008 Princeton, NJ November 24, 2008 East Lansing, MI December 1, 2008 Hanover, NH December 4, 2008 Indianapolis, IN

A Writing Program that Works (Grades 4-12)

Which date/location? Select One December 2, 2008 Andover, MA December 4, 2008 Sturbridge, MA December 5, 2008 Southbury, CT

Thinking and Writing Across the Curriculum for the Elementary Grades (1-5)

Which date/location? Select One October 22, 2008 Columbus, OH November 20, 2008 Princeton, NJ December 2, 2008 Sturbridge, MA December 5, 2008 Andover, MA

2. How did you learn about the workshop?

Website     Workshop Mailer  Email    Other

3. How do you wish to pay the registration fee?

PO     Credit Card **      Check

** For security reasons, please call 1-800-932-4477 with your credit card information at your earliest convenience.

4. If you will be using a Purchase Order, what's the PO number?

         PO # 

5. A group discount is available for groups of  5 or more. Will 5 or more people be attending from your school or district?

Yes     No     Not Sure

Please list the names of all those being registered for the workshop:

6. Billing Contact: * REQUIRED

* Name
* E-mail
* Phone
Fax
School
* Street/PO Box
* City
* State
* Zip

7. Registration & Confirmation Contact: (if different from billing)

Name
E-mail
Phone
Fax
School
Street/PO Box
City
State
Zip

8. Enter any additional comments in the space provided below: