Registration Form
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| First Name* | |
| Last Name* | |
| Position* | |
| Institution (No punctuation)* | |
| Department | |
| Address* | |
| City* | |
| State* | |
| Zip Code* | |
| Phone* | |
| Email* | |
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| How did you hear about the workshop? |
Email Colleagues Internet Search Conference I attended Other
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| Are you interested in learning more about an optional two-day in-person retreat (6/13-14) with an Alverno consultant? |
Yes, contact me regarding additional fees and options.
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| Workshop Options* |
$1,100 (Individual Rate) $975 (per person Team Rate, 2 or more from same institution)
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| Payment Options* |
Check Credit Card Invoice My School
Please include contact name, email,
invoice address, and PO # if needed
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