Registration Form For Leadership Development Series Name of Organization(Required) Full Name of Contact Person(Required) Email(Required) Phone(Required)Billing Address(Required) Mode of Instruction(Required) Virtual In-Person If In-Person, please provide complete address of training location. DAY 1 - Preferred Date of Workshop(Required) MM slash DD slash YYYY DAY 1 - Preferred Time of Workshop(Required) Hours : Minutes AM PM AM/PM DAY 2 - Preferred Date of Workshop(Required) MM slash DD slash YYYY DAY 2 - Preferred Time of Workshop(Required) Hours : Minutes AM PM AM/PM DAY 3 - Preferred Date of Workshop(Required) MM slash DD slash YYYY DAY 3 - Preferred Time of Workshop(Required) Hours : Minutes AM PM AM/PM DAY 4 - Preferred Date of Workshop(Required) MM slash DD slash YYYY DAY 4 - Preferred Time of Workshop(Required) Hours : Minutes AM PM AM/PM DAY 5 - Preferred Date of Workshop(Required) MM slash DD slash YYYY DAY 5 - Preferred Time of Workshop(Required) Hours : Minutes AM PM AM/PM Workshop Topics Included are: I understand. ►Principals of Child Development ►Best Practices in Quality Programming ►Nutrition and Health ►Safety & Security ►Effective Administrative Systems ►Effective Supervision ►Developing Your Staff's Skills ►Building a Staff Team ►Adverse Childhood Experiences ►Limiting Liabilities & Risk Management No. of Participants(Required) 1-20 21-30 Payment Method(Required) ACH Check I understand that: Yes• $5,400 up to 20 people maximum. • $6,600 for up to 30 people maximum. • Additional fees for this 30 Hour training series for materials, supplies and travel will be added for in person workshops, $300 - $400 will be added depending on the number attendees. • All payments must be paid 2 weeks prior to the workshop date via check or ACH only.NameThis field is for validation purposes and should be left unchanged.
