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PDP0707A

Western Region

2007-08

Registration Form

Professional Development Workshops

Complete the following information, check off the workshop or event, and fill in the subject session you wish to attend. For additional registrants, please duplicate this form and ask each registrant to fill out a separate form. No on-site registrations will be accepted. Be sure to retain a copy for your records. Questions: Call 800 787-7477, ext. 1, or e-mail workshopreg@collegeboard.org. Mail: The College Board– WRO, P.O. Box 234093, Ansonia Station, New York, NY 10023-9424, Fax: 866 549-6810.

Mr Ms Mrs. Dr.

First:

Last:

Title:

School:

Institution Address:

City:

State:

Zip:

Home Address:

City:

State:

Zip:

School Telephone: (

)

Home Telephone: (

)

Fax: (

)

Anchorage

Bartlett High School

1 Day

10/26/07

10/12/07

$150

$175

C

1 Day

3/22/08

3/7/08

$150

$175

C

Phoenix

Pinnacle High School

1 Day

12/1/07

11/16/07

$150

$175

N, E, C

Tucson

Salpointe Catholic High School

1 Day

3/15/08

2/29/08

$150

$175

C

Alhambra

Alhambra High School

1 Day

2/9/08

1/25/08

$150

$175

N, E, C

Fresno

Sunnyside High School

1 Day

10/6/07

9/21/07

$150

$175

N, E, C

La Jolla

La Jolla High School

1 Day

10/13/07

9/28/07

$150

$175

N, E, C

Los Angeles

Occidental College

1 Day

10/27/07

10/12/07

$150

$175

N, E, C

Orange

Chapman University

1 Day

3/8/08

2/22/08

$150

$175

N, E, C

Sacramento

John F. Kennedy High School

1 Day

10/20/07

10/5/07

$150

$175

C

San Mateo

Aragon High School

1 Day

2/2/08

1/18/08

$150

$175

N, E, C

Walnut Creek

Las Lomas High School

1 Day

12/1/07

11/16/07

$150

$175

N, E, C

Greenwood Village

Cherry Creek High School

1 Day

11/17/07

11/2/07

$150

$175

N, E, C

Lakewood

Jefferson County School District

1 Day

3/8/08

2/22/08

$150

$175

C

Honolulu

Henry J. Kaiser High School

1 Day

2/2/08

1/18/08

$150

$175

C

Las Vegas

Del Sol High School

1 Day

11/3/07

10/17/07

$150

$175

C

Reno

McQueen High School

1 Day

12/15/07

11/30/07

$150

$175

C

Medford

South Medford High School

1 Day

11/17/07

11/2/07

$150

$175

C

Salt Lake City

Highland High School

1 Day

10/27/07

10/12/07

$150

$175

N, E, C

Bellevue

Newport High School

1 Day

10/20/07

10/5/07

$150

$175

N, E, C

Spokane

North Central High School

1 Day

3/15/08

2/29 /08

$150

$175

C

CA

CO HI NV

OR UT

WA

The College Board frequently records images from its meetings, conferences and forums, and related events. By registering, you grant us the right to photograph and/or tape-record (audio and/or video) your image and make use of it in our publications, materials, and Web site. If photographs may be taken during a meeting, or if a meeting or session is to be audio or video recorded, you will be notified beforehand.

Do not send me information and news regarding College Board services, products, and other offers via e-mail.

AZ

AK

state

N=New

E=Experienced

duRation

staRt date

RegistRation deadline

Teacher

Preferred E-mail Address: Please check your primary institutional role: Administrator

Counselor

Credit Card Number:

Exp. Date:

Signature (required):

You can fax credit card registrations to 866 549-6810. Your credit card will be charged the lowest appropriate rate depending on the membership status of your institution on College Board records.

CitY

Total Registration Fee $ ___________________ Payment method: Check made payable to The College Board (Participants’ names must be listed on all checks and purchase orders.) Purchase Order

_________________

Visa

MasterCard

American Express

Discover

(A copy of the PO must accompany your registration.)

WoRkshop loCation

C=Combined

N, E=New and Experienced Sessions Offered

MeMBeR pRiCe

nonMeMBeR WoRkshop

pRiCe

CheCkBox

level

Fill in suBjeCt Code. see inseRt FoR Code listing.

College Board, AP, AP Central, AP Vertical Teams, Pre-AP, and the acorn logo are registered trademarks of the College Board. connect to college success is a trademark owned by the College Board.

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