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Vermont MIDI Logo   Registration for Professional Development Workshop on June 21st, 2007
   



Spring Workshop Registration

Summer Institute 2007

 
2007 Professional Development Workshop

All Registrations Will Receive Email Confirmation

Just complete this form. Click on Submit when ready to send. Only click Submit once! A confirmation window will appear when your registration is complete. The information given here will go through a third party for processing, so it is not secure. Do not send a credit card number. However, the third party guarantees the privacy of your information.

This form may also be printed and
faxed to: 802-879-3384
or mailed to: Sandi MacLeod, VT MIDI Project, Inc.
30 Steeplebush Rd., Essex Junction, VT 05452

Questions? Contact Sandi MacLeod by email or by phone: 802-879-0065


Checks, money orders, and purchase orders
should be made out to
:


VT MIDI Project, Inc.,
30 Steeplebush Rd.
Essex Junction, VT 05452


Name:
Home Street Address:
City/Town:
State & Zip:
School/Organization Name:
School/Organization Street Address:
School/Organization City/Town:
School/Organization State & Zip:
Email Address:
Home Phone:
Work Phone:
What method of payment do you plan to use?Checks can be made out to: The Vermont MIDI Project, Inc., 30 Steeplebush Dr., Essex Junction, VT 05452 Check
Money Order/Cashier's Check
Purchase Order
PO Number:
PO Amount:


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