MainStreet Academix

WEBINAR REGISTRATION FORM
Pillars of a Respectful School (2008-2009)

Please complete the form below to register for our upcoming webinars

Name:

School Name:

Address:

City:

State:

Zip:

Phone:

Work Phone:

Email:

Number of Attendees:

Position:

Others:

Select Webinars:

Webinars are $125.00 each.

Webinar #1: Strategies for Student Engagement to Improve School Climate and Learning 11/18/2008 3:00-3:50pm EST. (Tuesday)
Webinar #2: Utilizing Diverse Student Leaders as Partners in School Improvement 1/8/2009 3:00-3:50pm EST. (Thursday)
Webinar #3: Effective Student Discipline: Assessing, Preventing and Responding Using Positive Behavioral Interventions and Support (PBIS) 1/21/2009 3:00-3:50pm EST. (Wednesday)
Webinar #4: How Student and Adult Leaders Collect and Use School Climate Data to Improve School Climate and Learning: A Step By Step Approach 2/5/2009 3:00-3:50pm EST. (Thursday)

TOTAL($):

PAYMENT METHOD

* Please make checks payable to Main Street Academix

Mailing Address:
Holly Preble,
Main Street Academix,
24 Rush Road, Henniker, NH 03242.