Director’s Training Registration Form

Facilitator:   Althea Penn, Educational Consultant

Bright from the Start DECAL approved trainer/training

Website:  http://altheapenn.tripod.com 

E-mail:  penntraining@yahoo.com

678.557.8684

 

Please print and complete all information.

NAME OF CENTER/SCHOOL or primary attendee: _____________________________________________________________

 

MAILING ADDRESS:__________________________________________________ CITY ____________________  ZIP __________

 

PHONE NUMBER:______________________FAX NUMBER:______________________  E-MAIL ____________________________

 

Center Type:  SCHOOL/Center based  __ Group Day Care __  Family Day Care__  WEBSITE _______________________________

Who needs to attend:  Owner, Director, Assistant Director, Administrative Assistant, Summer Camp/Afterschool Director, Lead Teacher or Bookkeeper.

 

Attendees

Name (Last, First)

Title

Telephone

E-mail or mailing address

(if different from above)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SESSION

Session Title

Date

Location

Early Bird Registration

Regular

Registration

 

# of

Atten

-dees

Amt

Due

Director’s Training

 

 www.mapquest.com

 

 

 $

 

 

Registration confirmation and directions will be mailed or emailed to you upon receipt of this form.

 

Please sign below after reading the following important information:

Early Bird Registration (deadline receipt on or before 30 business days prior to the workshop)              $435.00

Regular Registration (paid 5-29 days prior to the beginning of workshop)                                                $485.00

Assistant Director or other employee attends the same session at $250 each with the paid advance registration of a Director 

Walk-in add $25.00 

Registration includes valuable forms and a director’s manual based upon the following textbook:  Click, Phyllis. Administration of Programs for Young Children. 6th/7th ed. Albany, NY: Delmar Publishers, 2003 (2007).

 

Cancellations/Substitutions:  Substitutions may be made up to two days prior to the session.  If you cancel your registration up to five business days before the workshop, your registration fee will be refunded less a $30 service charge.  Cancellations and substitutions must be made in writing (email acceptable).  Registration may be transferred to a later session date once.  No refunds will be allowed after registration deadline (5 days prior).

Please arrive 15 minutes before the start time of the training.  Participants who arrive later than the first 10 minutes of the training may not be permitted to enter and will not receive credit for the course.  To allow for the best training experience for everyone, children and cell phones are not permitted.  Calls may be made during scheduled breaks.  Participants must be present during direct instruction periods in order to receive credit for the course, therefore you must return in a timely manner from all breaks.

 

 Tax Deduction:  The expenses incurred for ongoing professional development are tax deductible, when completed to maintain or improve professional skills.  Your accountant can provide details. 

 

Please make check payable to and mail the completed registration form along with a check or money order to:

Althea Penn or Penn Consulting P. O. Box 49254, Atlanta, GA 30359

Photocopy as needed. Questions? Please call the training registration center at 678.557.8684

 

Signature _____________________________    Date ___________   Check or m.o. # ______________       or Cash ___

 

 

 

Method of Payment-Charge Authorization Form

 

Mail or email to:  Penn Consulting, P. O. Box 49254, Atlanta, GA 30359 or penntraining@yahoo.com.

 

I authorize Penn Consulting to charge my credit/debit card:  o  MasterCard   o  Visa the following fees and charges:

 

Registration fee director’s training                      ______________________

 

Per Diem (Travel expenses) at $.585/mile            ______________________

 

Total charges                                                    ______________________

 

Name (as it appears on credit card):

 

Company ___________________________________________________________________________

 

Last  ________________________________  First  ________________________  MI ____________

 

Street Address ________________________________________________________________________

 

City _________________________________________________ State _____  Zip Code _____________

 

Phone ____________________________   Phone #2 ______________________

 

Card No. ____________________________________________________

 

Expiration Date _______________________  CV No. (on back of card) ________________________

 

Authorized Signature _______________________________________ Date ___________________________