Professional Development Supported by Academic Innovations

Workshop Registration

Which event are you registering for?

General Information (ALL FIELDS REQUIRED)

Your First and Last Name:
Please fill in your First Name.

Please fill in your Last Name.
Job Title:
Please fill in your Job Title.
E-mail:
Please fill in your Email.
Your Email Does Not Match
Confirm E-mail:
Please fill in your Email.
Your Email Does Not Match

Source/Coupon Code (IF APPLICABLE)

Source/Coupon Code:

When source/coupon codes are used, they apply to all registrations in the group. Please start a separate registration process for any attendees in your group who should not have the source/coupon code applied to their fee.

School Information (ALL FIELDS REQUIRED)

School District:
Please fill in your School District.
School/Agency Name:
Please fill in your School/Agency Name.

Additional Information (ALL FIELDS REQUIRED)

We are looking for a solution to serve:
Secondary Students
Dual Credit Students
Postsecondary Students

Please choose at least one group to serve.

Which event are you registering for? Select a workshop from the list below. --------- Please provide a Career Choices workshop in my area.

Which event are you registering for?