Registration for IDM Institute in Burlington Wednesday June 26 -Thursday June 27, 2019
Your First Name *
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Your Last Name *
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Your Professional Title *
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Your Organization or School District *
Required
Your School (if applicable)
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Your Preferred Email Address *
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Phone (optional) *
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Professional Role *
Grade Level(s) of students with whom you work *
Required
Number of seats you would like to reserve *
If you selected two or more seats, please list attendees, if known. T.B.D. is acceptable.
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How will you be paying the registration fee? *
The options below are the only payment options. Unfortunately we cannot accept credit cards, PayPal, etc. Upon registration we will generate and email you an invoice. Checks must be received by June 15, so please submit POs to your district for payment as soon as possible once you have the invoice. Thank you for your cooperation.
Please calculate and enter the amount owed.
Cost: $295 per person; $1100 per team of four people
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If paying by PO, please provide the mailing address of your district or organization's Accounts Payable office.
We will send you an invoice shortly following submission of this form, will which tell you or your business office where to mail the check (123 Cambridge St. Burlington, MA 01803; or email it to bercury@bpsk12.org)
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If paying by personal check, please provide your full mailing address
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A lunch will be provided both days. Please inform us of any special dietary needs or requests.
Please note: We will try to accommodate needs but cannot guarantee absence of or no cross-contamination from allergens.
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