Mindset 1.0 & 2.0 Registration ~
March 4 and 25, 2020. The 577 Foundation, Perrysburg, OH 8:00 am - 3:00 pm.

Thanks for your interest in participating in this workshop! You will receive notification of your registration upon completion of this form. Invoices for payment will be sent out after the minimum number of participants needed to offer the workshop is reached (typically 2-3 weeks prior to the start of the workshop). Registration is subject to a $50 cancellation fee if canceled within 10 days of the first session since materials are ordered in advance. We really are looking forward to our creative work together!
First Name *
Careful here... you don't want us calling you "Alice" by mistake!
Your answer
Last Name *
Your answer
Email Address [Gmail preferred if you have one] *
Please use your GMAIL account if you have one (but no worries if not!). Please check for accuracy. This email address will be used to send your confirmation that we received your registration.
Your answer
Growth Mindset 1.0 (new) or 2.0 (veteran) session?
Contact MOBILE Phone Number *
Please check for accuracy. This phone number will be used in case of last minute schedule changes/cancellations due to weather conditions, etc. So use a personal number, not the school number ;-) It will NOT be shared with others.
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Grade Level(s) Taught *
Select all that apply.
Your answer
Subject(s) Taught *
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Organization Name *
Please enter the name of your Company, School District, or Organization.
Your answer
School Building Name
For preK-12 Teachers and Administrators Only. Leave BLANK if you do not work in a school building.
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Dietary Considerations?
Please check all that apply
Billing Preference *
How would you like to pay for your registration?
Billing Information: Please provide the needed contact information for billing: *
Who should we bill? Provide their Name, Position, Phone, and Email Address. We can't process payment or approve and/or finalize your registration without this information... Please enter all of it ;-)
Your answer
Participation Agreement
Please read the agreement below regarding participation in this series.

I understand that the science mini-series is a connected two day series and I am committed to attending both sessions. By selecting "Yes" on this registration form I commit to attend the entire workshop (barring any unforeseen family emergencies). Cancellation of this registration is subject to a $50 fee if cancelled within 10 business days of the first session.
Participation Agreement *
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