2017 Malheur Summer Institute Registration Form
Please provide the following contact information, dates of attendance, and registration for exceptions (Bus Driver Training). All other sessions are first come first serve. First Aid CPR will have AM/PM sessions each day with a 20 person maximum, first come, first serve. Please reference the MSI flyer for times/descriptions.

If you plan to attend the Bal-A-Vis-X session you will need to also register here: http://www.malesd.k12.or.us/workshops/2673/bal-vis-x-training . (There is a limited number of spots that will fill up rapidly.)

State *
Last Name *
Your answer
First Name *
Your answer
Email Address *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
School District *
If no school district write none. If local service provider, please write the agency or daycare name.
Your answer
Will you attend any sessions on Monday, July 24th? *
This is for lunch count purposes.
Will you attend any sessions on Tuesday, July 25th? *
This is for lunch count purposes.
Will you attend any sessions on Wednesday, July 26th? *
This is for lunch count purposes.
Class registration exceptions.
Yes-Attending
No-Not Attending
Bus Driver Training (Tues July 25th) Location TBD
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