NJMEA Summer Workshop 2017 Online Registration
Online registrations must be received no later than July 30. Please remit payment in the form of a check to the address provided on the workshop website. Registration fee BEFORE July 15 = $80 AFTER July 15 = $100.
Email address
Personal Information
Last Name
Your answer
First Name
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Home Phone
xxx-xxx-xxxx
Your answer
Cell Phone
xxx-xxx-xxxx
Your answer
Email Address
Please use an address that is checked regularly, especially during the summer months
Your answer
Confirm Email Address
Your answer
Professional Information
Current School District
Your answer
Current Teaching Assignment
Check all that apply
Required
Current Teaching Assignment Grade Level
Check all that apply
Required
NAfME Number
You MUST be a member of NAfME in order to participate - expiration date must be good through August 31, 2016. You can go to http://musiced.nafme.org/join to register or renew.
Your answer
NAfME Membership Expiration Date
MM/YYYY
Your answer
Workshop Interests
Please choose, in order of importance, which areas of the workshop interest you most. This will help us better meet the needs of our membership.
Choice #1
Choose ONE
Choice #2
Choose ONE
Choice #3
Choose ONE
Choice #4
Choose ONE
Choice #5
Choose ONE
If an instrumental reading and playing session were available, would you be interested in participating?
If you selected YES above, which instrument would you play?
Your answer
Do you plan to attend the Choral Reading Session (s)?
If you answered YES above, which session to you plan to attend
Click all that apply
Would you like to be included on the Colleague Networking List?
This list will be distributed to all workshop attendees and can be used to connect with colleagues in similar fields to gain resources, brainstorm, etc.
Form Submission Information
Please complete the registration fee agreement below
I plan on making a payment in the following form:
Do not send payments via certified mail
Required
I understand that registering On or BEFORE July 15 will cost $80. Registering AFTER July 15 will cost $100. I also understand that NO REFUNDS are available AFTER July 15th.
Please submit payment to: NJMEA Summer Workshop c/o Sue Mark 3 MacKenzie Ct Sewell, NJ 08080
Required
Please click submit only ONCE to avoid duplicate registrations. There is no need to send a hard copy of the registration form along with your payment. Please DO NOT send payments via certified mail.
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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