MSU Summer Band Director Workshop Registration Form
The workshop will be held June 12-14, 2017 at Northwest Rankin High School in Flowood, MS (Jackson area). The clinic starts on Monday morning at 8:00 and concludes on Wednesday at noon. This is the registration form for the workshop, but the registration fee of $25.00 will not be paid until the morning of the first session (June 12th). The deadline to register is Wednesday, June 7, 2017. CEUs are available separately to those who attend all clinic sessions, and instructions for obtaining them will be given at the close of the last clinic session. Questions? Contact us at 662-325-2713 or by email at eklance@colled.msstate.edu PLEASE PRINT A COPY OF THIS REGISTRATION FOR YOUR RECORDS BEFORE YOU HIT SUBMIT!
First Name
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Last Name
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Mailing Address (street or P.O. Box)
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Mailing Address (city)
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Mailing Address (state)
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Mailing Address (zip code)
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Preferred phone number (xxx-xxx-xxxx)
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Email address
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School Name
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In what areas do you teach? (check all that apply)
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Are you currently an undergraduate college student?
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