Institute for Educational Development

Seminar Registration Form


Improving the Emotional Well-Being of Your Students to Reduce Challenging Behaviors and Increase Learning (Grades 6-12)
PORTLAND, ME on March 1

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

Pricing Information $279.00     Group Price: $259.00
Register 3 or more to this seminar at the same time to receive the Group Price discount.

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 with me

 My brochure doesn't have a Priority ID Code
 I don't have a brochure
Participant Information
* = Required Field
Ms./Mrs. Mr.

Participant School

Home Address

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.
Group Participants
There are no Group Participants.

To add participants to a group registration use the "Add Participant to Group" button above.
Payment Information Credit Card School or District P.O.
Bill Home Bill School

Visa   Mastercard   Discover

*Required for credit card payments!
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.

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

Contact Us




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