Registration Form
High Schools That Work and Making Middle Grades Work
Transitions Summer Institute
June 9-13, 2008

Please select the insitute the team will attend: (If you are sending teams to more
than one institute, please use a separate registration for each.)


Team Leader:
(Only Teams Will Be Accepted)
Registration Fee-$550 per Team Member
* All fields are required
First Name:   Last Name:   Date:  
Title:  
School/Organization:  
Mailing Address:  
City:   State:   Zip Code:  
Summer E-mail Address:  
Summer Phone Numbers:  
Summer Fax:  

Members:
3-person teams, leader plus 2 members required
Last Name First Name
Title
Last Name First Name
Title
Last Name First Name
Title
Last Name First Name
Title
Last Name First Name
Title
Please send registration and payments to:
Southern Regional Education Board
Att: Leonard Gatungo
592 10th Street, N.W.
Atlanta, GA 30018-5776
Phone: (404) 875-9211
Fax: (404) 872-1477
Indicate method of Payment
(Registration is not confirmed until payment is received.)


 Check/Money Order Enclosed Check #
Purchase Order #
CSR ID #