Institute for Educational Development | Professional Staff Development

Seminar Registration Form

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TD96F1-CEN

DIFFERENTIATED INSTRUCTION: Using AI to Increase Student Learning and Decrease Teacher Prep Time (Grades K-6)
Live Online Event on November 17, 2025 from 9:00 am – 3:30 pm

If you prefer, print a blank registration form to mail or FAX.

Pricing Information $295.00 Group Price: $275.00

Fee includes seminar registration, refreshments, a personalized certificate of attendance, and an extensive resource handbook.

Priority Code

If you are responding to one of our brochures, please take a moment to fill out your Priority Code (the six digit number on the mail label next to the word "ID")

I have my brochure / e-mail
* Priority ID Code:

If you don't have your Priority ID code, how did you hear about this event?

Email
Mailed Brochure
Website
Other/Colleague

Participant Information

* = Required Field

* First Name:
Middle Name:
* Last Name:
* Position:
* Grade:

Participant School
* School Name:
* Participant Email:
* Re-enter Email:
School Phone:
* School Address:
* City:
* State:
* Zip:

Home Address * Home Phone:
Home Address:
City:
State:
Zip:

Add Participant to Group

If additional individuals are registering with you, click the "Add Participant to Group" button. When all group participants have been added, continue with the remainder of the form.

Payment Information * Payment Method:

Credit Card

School or District P.O.

Bill Home

Bill School

*Visa, MasterCard, Amex and Discover only

Cardholder's Name:
Card Number:
CVV Number:

Where is my CVV Code on my card?

On Visa, Mastercard, and Discover cards:
Turn your card over and look at the signature box. You should see either the entire 16-digit credit card number or just the last four digits followed by a special 3-digit code. This 3-digit code is your CVV number / Card Security Code.
On American Express cards:
Look for the 4-digit code printed on the front of your card just above and to the right of your main credit card number. This 4-digit code is your Card Identification Number (CID/CVV). The CID/CVV is the four-digit code printed just above the Account Number.

Expiration Date:

*Required for credit card payments!

Billing Zip code:

Purchase Order

Please Note: some districts require that we receive a purchase order issued to you for the function BEFORE you can be registered for the seminar. If this is required by your district, please print this page, fill it out and have it faxed to us together with the purchase order.

School or District P.O. Number (if available):

Please mail or fax to us the signed Purchase Order (P.O.) as soon as possible.

Note that in order to bill to a specific district, we must have a hard copy of that district's purchase order. Otherwise a bill in your name will be sent to your school.

Once we receive the district's purchase order, we will re-invoice to the district.

Please mail or fax to us the signed Purchase Order (P.O.) as soon as possible.

Note that in order to bill to a specific school, we must have a hard copy of that school's purchase order. Otherwise a bill in your name will be sent to you.

Once we receive the school's purchase order, we will re-invoice to the school.

Mail:
Institute for Educational Development
P.O. Box 718
Medina, WA 98039-0718

Fax: 425-453-4103
Email: po@iedseminars.org

Please leave this blank:

Submit Registration Form

After you have completed the entry of all registrants, click the "Submit Final Registration" button.

Phone:
1-800-260-8180

Fax:
1-425-453-4103

Email:
info@iedseminars.org

Postal Mail:
Institute for Educational Development
P.O. Box 718
Medina, WA 98039-0718