Cost

Significant financial contributions from the Institute sponsors have made it possible to offer this program at a discounted rate. The reduced fee of $600 per participant includes tuition and all materials, plus three nights lodging, three continental breakfasts, three lunches, and two dinners. For those traveling by air, an additional night stay-over may be arranged for an additional charge.

Application and Selection Process

Enrollment in this unique professional development program is limited, and a competitive application process will be used to select participants. Please complete the online application form with a $200 deposit before March 1, 2010. The deposit is fully refundable if the applicant is not selected to participate. Applicants will be informed of the status of their applications no later than April 1, 2010. The balance of $400 will be due no later than April 30, 2010.

Application Form

Personal Information

First Name *
Last Name *
Name for Name Tag *
Gender Select One Male Female *

Professional Information

Position *
Institution *
Department *
Courses Taught
(limit 500 characters)
500 characters left *

Contact Information

Address 1 *
Address 2
City *
State *
Zip Code *
Phone Number *
Fax Number
Email Address *
Emergency Contact
(limit 600 characters)
600 characters left

Personal Options

Smoking Select One Smoking Non Smoking *
Special Meal

Payment Information

Payment Method Select One Check Credit Card *
Payment Amount Select One $200 - Deposit $600 - Entire Balance *
Payment Notes