Request edit access
2017 Charter School Leadership Institute Registration
Registration for the 2017 Charter School Leadership Institute is now open! There will be a small non-refundable registration fee of $55 to cover the costs of the Institute. Only checks will be accepted at the registration table.

To register:
1) Submit the following online form for EACH participant. If you are unsure of who may attend due to changes in personnel, please indicate his or her classification (SCHOOL ADMINISTRATOR/LEAD TEACHER/BOARD MEMBER) in the name category and notify our office of the participant's name when the hiring process is complete.

2) Print the completed form and mail it with your non-refundable registration fee of $55 to: Office of Charter Schools, 6303 Mail Service Center, Raleigh, NC 27699-6303. Please make checks payable to NCDPI-Cash Management Section and write the code 0801-435600-160048971000 on your check.

Your registration is not complete unless the online form, the printed form, and a check for the registration fee are received. In the event that the originally registered participant is unable to attend, the school may send an alternate. In the past, the Institute filled quickly, so it is important that you submit all materials early.  

CONFERENCE LOCATION: Voyager Academy (High School) - 4302 Ben Franklin Blvd, Durham, NC 27704

Morning break service and a full lunch for both days are included in the non-refundable registration fee. Participants are responsible for the cost of travel, lodging, and evening meals. Area hotels include:
(1)  Microtel Inn & Suites by Wyndham  (120 Old Dogwood St, Hillsborough)
(2)  Holiday Inn Express Hillsborough (202 Cardinal Dr., Hillsborough)
(3)  Holiday Inn Express & Suites Mebane (149 Spring Forest Dr., Mebane)
(4)  Hilton Durham near Duke University (3800 Hillsborough Rd, Durham)


For questions or additional information, please contact Brian Smith at (919) 807-3492 or brian.smith@dpi.nc.gov.
Sign in to Google to save your progress. Learn more
NAME *
CLASSIFICATION *
How many total years of experience do you have as a charter school leader (i.e., administrator, board member and/or lead teacher)?
SCHOOL CODE: *
SCHOOL: *
STATE BOARD REGION: *
PARTICIPANT'S E-MAIL ADDRESS *
PARTICIPANT'S PHONE NUMBER *
PLEASE INDICATE THE SESSION DATES YOU WOULD LIKE TO ATTEND. *
You may attend multiple dates during the Institute.
Required
Before you click submit, please print this document and mail it with your non-refundable registration fee of $55 with the code 0801  435600  160048971000. Your registration is not complete unless the online form, the printed form, and a check are received by OCS by September 9, 2016.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms