DISTRICT REGISTRATION FORM
Paramus Summer Literacy Institute
Email address *
District: *
Your answer
Date *
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Administrative Contact: *
Your answer
Title: *
Your answer
Phone: *
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Email: *
Your answer
I am registering the following number of district employees for the Paramus Summer Literacy Institute. (Please submit along with the individual registration forms for all participants.)
Through May 31, 2019, the cost is $500 per participant (or $1,350.00 for every 3 participants) and the cost per Administrator is $325 After May 31, 2019, the cost is $550 per participant (or $1,500.00 for every 3 participants) and the cost per Administrator is $375
First-Time Participants (#) *
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Returning Participants (#)
Your answer
Total amount due for First-Time and Returning Participants *
Your answer
Administrators (#) *
Your answer
Total amount due for Administrators *
Your answer
Total amount due from district *
Your answer
*Please issue a purchase order by June 29th to secure your participation
By inserting my name below, I acknowledge that should a Participant/Administrator cancel, he or she should be replaced by another person, and that my district is responsible for payment for all registered individuals.
District Administrative Contact: *
Your answer
Date: *
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