2016 MALI SUMMER CONFERENCE
2016 Maine Arts Leadership Initiative Summer Conference Registration Form - Tuesday, June 28

The Maine Arts Leadership Initiative offers a one-day summer conference with a variety of outstanding workshops. This is a great way to kick off your summer that will provide you with ideas and materials on developing standards and assessment tools as well as other relevant hot topics. Join your colleagues from across the state and around New England in a collaborative learning environment.

Please go to https://docs.google.com/document/d/1AQ7v3kosh7ReRijqyQtPvYlukURtxzjRXW_1X5NfxqM/edit?usp=sharing to familiarize yourself with the offerings and schedule

For conference (free) parking, directions, times, workshops please go to www.maineartsassessment.com.
First Name *
Your answer
Last Name *
Your answer
Position Title
Educator/Professor/Student/Etc...(Art, Music, Theater, Dance?)
Your answer
Email Address *
Your answer
Summer Mailing Address *
If your email and phone are not working....how best to contact you
Your answer
City (and state if other than ME) *
Your answer
Zip Code *
Your answer
Phone Number *
Best number to reach you before and during conference
Your answer
Emergency Contact *
Name, relationship and best way to contact in case of an emergency.
Your answer
Name of School or Institution
Your answer
Address of School or Institution
Your answer
Work Phone Number
Your answer
City
Your answer
Zip Code
Your answer
Dietary needs that you would like for us to be aware of?
Your answer
Do you have a medical condition that you would like for us to be aware of? (This will be treated confidentially and shared only if needed with the appropriate parties)
Your answer
Contact Hours or CEUs (up to 6 contact hours or .6 CEUs) *
Please understand that there will be an additional fee from the CEU granting institution.
FIRST Session Choice *
(select one)
SECOND Session Choice *
(select one)
THIRD Session Choice *
(select one)
FOURTH Session Choice *
(select one)
The workshops are provided by the Maine Arts Leadership Initiative teacher leaders. Are you interested in learning more about MALI? If so, please provide your contact info below.
Your answer
Media Release *
Social media will be used for networking throughout the MALI convening. Please confirm that you understand that photos, interviews and/or videos will be taken and may be posted on the social media accounts for the conference throughout the conference.
Refund and Cancellation Policy - We recognize and understand that events come up that require a change in plans. *
Request for a full refund must be made by 5:00 PM Friday, June 24 to Argy Nestor at argy.nestor@maine.gov. I have read and agree with the above refund and cancellation policy.
Required
Ready to Complete your registration? *
This will bring you to the payment link....please remember your registration is only complete with FULL payment. Cost: $50, teams of 3 or more, $40 per attendee. Full-Time Student - FREE.
Ready to Complete your registration? *
This will bring you to the payment link....please remember your registration is only complete with FULL payment. Cost: $50, teams of 3 or more, $40 per attendee. Full-Time Student - FREE.
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