NJSMA Elementary Workshop: DAVID FREGO
Registration Form for NJSMA Elementary Music Division Columbus Day Workshop
Date: Monday, October 14, 2019
Time: 9:30am-3:30pm. (Registration at 9:00am)
Location: The Mansion at Mountain Lakes (90 Rt. 46 East, Mountain Lakes, NJ)
Registration fee: $95
Registration fee includes: Full Day Professional Development Workshop, Continental Breakfast and Buffet Lunch
(Discounted NAfME/NJMEA member fee: $90. Current NAfME ID # and expiration date required)

PD Certificates will be provided.
Email elementary@njsma.com with any questions.

If your school is paying by Purchase Order, please share the below information with your business office:
Our official name is: North Jersey School Music Association.
The organization address is:
180 Bloom St. #109
Hackensack NJ 07601
The Tax ID# is 22-3629391.
Registration fee payable to NJSMA.
Mail check or purchase order to: Karen Andruska, Registrar, 193 Levinberg Lane, Wayne, NJ 07470
IF YOU ARE REGISTERING AFTER 10/9, YOU MUST PAY AT THE DOOR, CASH OR CHECK.

NJSMA Elementary Division 2019 Columbus Day Workshop
David Frego (10/14/19) Workshop Registration Form
NJSMA Elementary Music Division Columbus Day Workshop
Last name: *
Your answer
First name: *
Your answer
School district *
Your answer
School name *
Your answer
School town and state *
Your answer
Preferred email address *
Your answer
Indicate method of payment. *
The registration fee is payable to NJSMA. Mail check or purchase order to: Karen Andruska, Registrar, 193 Levinberg Lane, Wayne, NJ 07470.
If you indicated that you are a current NAfME member, please list your NAfME ID #:
Your answer
If you indicated that you are a current NAfME member, please list your current expiration date (must be valid on 10/14/19):
MM
/
DD
/
YYYY
I understand that I am not considered registered until either a check for $95* or notification of PO processing has been received. (*$90 for current NAfME members.) *
I understand and will share the following with my school's business office: The organization (NJSMA) address is: 180 Bloom St. #109 Hackensack NJ, 07601. The Tax ID# is 22-3629391. Registration fee payable to NJSMA. Mail check or purchase order to: Karen Andruska, Registrar, 193 Levinberg Lane, Wayne, NJ 07470 *
How did you hear about the workshop? *
Required
If you have dietary restrictions, please explain below (i.e. gluten free). The venue provides gluten free options.
Your answer
Thank you for completing the registration form. PD certificates will be provided at the conclusion of the workshop. You will receive registration confirmation via email upon receipt of either a check or PO.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of North Jersey School Music Association. Report Abuse - Terms of Service