Flint Hill Registration

We will not share your information. An * indicates a required field.

Main Registrant Contact Information

First Name *

Last Name *

Employer

Email Address*

Phone Number

Address Line 1 *

Address Line 2

City/Town/Municipality *

State/Province *

Postal Code *

You will have various payment options after making workshop selections. They include:

• - Online- the invoice sent to you from the LCIRT office will contain a link to pay online.
• - Check via postal mail
• - Purchase Order
• - Credit Card via phone 802.387.1662

Multi-day 15% discount will be applied to the invoice, if applicable.

Indicate multiple registrants (up to 3) to take advantage of group pricing. (Multiple registrants must be from the same school.) You can indicate multiple registrants without indicating which courses they will take. The form will ask for their name, email address and course selections. If you leave the course selections blank, we will email your co-registrants and ask them to fill out the registration form.

How many registrants will you be signing up? *

• 1 Registrant
• 2 Registrants
• 3 Registrants

How did you hear about us?

• Website Link
• Email
• Print Mail
• Social Media (LinkedIn, Facebook, Twitter)
• Friend or Colleague
• Other please specify:

Registrant 1

Attendees have the option to participate in as many (or few) sessions as preferred.

Registrant 1 Contact Information

First Name

Last Name

Email Address

Is this Registrant a Flint Hill faculty member?

• No
• Yes

Workshop Registration

You may register for one, two, three, or four workshops. Each workshop costs $150.

• August 13, 2013 - Teaching Academic Reading Comprehension with Common Core in Mind
• August 14, 2013 - Teaching Writing with Common Core in Mind
• August 15, 2013 - Managing the Impact of Executive Function Difficulty
• August 16, 2013 - Introduction to Learning Disabilities

Do you require any special accommodations? Please tell us by July 25th about any accommodations you require:

                                     Only 1 Registrant? Click here to skip down and submit.

Registrant 2

Attendees have the option to participate in as many (or few) sessions as preferred.

Registrant 2 Contact Information

First Name

Last Name

Email Address

Is this Registrant a Flint Hill faculty member?

• No
• Yes

Workshop Registration

You may register for one, two, three, or four workshops. Each workshop costs $150.

• August 13, 2013 - Teaching Academic Reading Comprehension with Common Core in Mind
• August 14, 2013 - Teaching Writing with Common Core in Mind
• August 15, 2013 - Managing the Impact of Executive Function Difficulty
• August 16, 2013 - Introduction to Learning Disabilities

Do you require any special accommodations? Please tell us by July 25th about any accommodations you require:

                                     Only 2 Registrants? Click here to skip down and submit.

Registrant 3

Attendees have the option to participate in as many (or few) sessions as preferred.

Registrant 3 Contact Information

First Name

Last Name

Email Address

Is this Registrant a Flint Hill faculty member?

• No
• Yes

Registration Fees

You may register for one, two, three, or four workshops. Each workshop costs $150.

• August 13, 2013 - Teaching Academic Reading Comprehension with Common Core in Mind
• August 14, 2013 - Teaching Writing with Common Core in Mind
• August 15, 2013 - Managing the Impact of Executive Function Difficulty
• August 16, 2013 - Introduction to Learning Disabilities

Do you require any special accommodations? Please tell us by July 25th about any accommodations you require:

or