Registration form for LOL Leadership Institute
June 26-July 9,2005

Enrollment is limited to assure quality. Early registrations receive priority. Late registrations will be accepted if space is available.

Payment is due in full by June 1, 2005. If a purchase order is issued it must be made for the full fee amount. Payments and purchase orders for all fees should be made payable to Education Development Center

Cancellations If you must cancel, a substitute participant is always welcomed. Otherwise $150 is non refundable; all additional payments are fully refundable up to May 30, 2005, non refundable thereafter.

Fee to attend this institute is $2,800 (Includes instruction from the Lenses on Learning authors and experienced Lenses on Learning facilitators, lodging from Sunday night June 26- Saturday Morning July 9, breakfast, lunch and snacks each day (except July 2 and 3rd), a full set of the Lenses on Learning materials-a $350 value). Fee is based on double occupancy rooms. Single accommodations are available for an additional $520

Questions
Phone: 617-618-2525
Email: cdt@edc.org

Contact Information

Mr. Mrs. Ms.

Name:

Professional Role

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If one of the parties paying the Institute Fee is not you, please provide the complete billing information below.

Institution

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Payment Information

I understand that I am responsible for my transportation to and from the institute location and for my dinner during the institute.

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Special needs (dietary or physical)

I want to share a room with

What do you hope administrators who enroll in your Lenses on Learning seminar will come away with?
What do you think might be difficult for them about learning this material?

What do you hope to learn by participating in the Lenses on Learning Leadership Institute?

What do you bring to the facilitation of a Lenses on Learning seminar?

If there is anything else you would like to add that you think is of relevance, please include it here.