CLEAR Summer Workshops Application 2017
As we work to solve a technical issue with our normal online registration, we are providing this form you can use in place of the typical application. All information from this form will be migrated to our application system when it becomes available; you will not need to reapply.

Please complete and submit this form to apply for our summer professional development workshops. No funds are due at this time; you will receive an email after our May 5 early bird deadline with further instructions about payments. We will have updated information online soon about campus accommodations and parking, as well as agendas for the workshops.

Early Bird Application Deadline:
May 5, 2017 ($15 application fee waived)

Regular Application Deadlines:
June 2, 2017 ($15 application fee will be assessed) for June workshops
July 7, 2017 ($15 application fee will be assessed) for July/August workshops

Email address
Name (first and last)
Your answer
Phone number (will only be used if we cannot reach you via email)
Your answer
City and state (or country)
Your answer
Language(s) you teach
Your answer
Level(s) you teach
Required
Workshop(s) for which you are applying (please note that prices do not reflect any discounts for which you may be eligible):
Required
Please share a brief statement of purpose – a few sentences about why you want to take the workshop that we will share with the workshop leader.
Your answer
Please list any comments or questions you have for our staff and we will get in touch with answers.
Your answer
If applicable, share the name of person who referred you to CLEAR (this person will receive a referral discount on his/her Summer 2017 workshop. See our website for more information about the referral discount and our multiple workshop discount.)
Your answer
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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