Online Registration Form

Course: Summer Leadership Institute, Date: July 9-12, 2012

If you don't already have an account with CEL, register here:

Set up a new account

E-mail address *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Password *

Confirm password *

Provide a password for the new account in both fields.

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Who will be attending?

You

You and other(s)

Other(s)

Enter your information

School District/Organization *

School

Address

City

State/Province

for U.S. and Canada addresses only

Zip/Postal code

First name *

Last name *

Middle initial

Preferred name

Current position/title

Daytime phone

Enter Attendee Information

How many attendees are you registering?

E-mail *

First name *

Last name *

Current Position *

What is the attendee's most recent position?

School District/Organization

(if different from above)

E-mail *

First name *

Last name *

Current Position *

What is the attendee's most recent position?

School District/Organization

(if different from above)

Total Cost $350.00

Total Cost $175.00

Payment method *

Credit Card (secure site)

Purchase Order

Check made payable to University of Washington

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Online Registration Form

Register participants here