Strategies for Engaging Every Student in Learning for Educators, Teaching Artists, University/ College Students and Community Arts Education Providers
August 21-23, 2016
Ralph A. MacMullan Conference Center,
Higgins Lake, Roscommon, MI
Please complete this form and email it to firstname.lastname@example.org or snail mail it to the VSA Michigan office at 111 East Kirby, Detroit, MI 48202. Respond as soon as possible, as the number of participants is limited.
I would like to register for the workshop.
I am an _____ Educator _____ Teaching Artist
_____ Community Arts Education Provider
_____ University/College Student (Indicate Major) _________________________________
I am an educator and interested in obtaining SCECHs. Yes_____ No_____
_____ I would like to attend the entire workshop.
_____ I would like to attend on Sunday and Monday
_____ I would like to attend on Monday and Tuesday
I would like to room with______________________________
I have the following dietary restrictions:
I require the following accommodations (e.g. large print, Braille, American Sign Language Interpretation):
_____ My registration check in the amount of $100 is enclosed, made payable to VSA Michigan.
_____ Please charge my credit card Number_________________________________ Exp. Date___________ Security Code__________ Billing Zip code___________________
Name as it appears on card
_____ I would like to be considered for a scholarship to attend this workshop. Please contact me by
_____ phone or _____ email to discuss this opportunity.