Third Annual Dean's Institute


Individual Attendee:
First Name:  
Last Name:  
Street Address:  
City:  
State:  
Zipcode:  
Phone Number:  
Email:  
School District:  
School District Contact Name:  
School District Contact Phone Number:  
Select your workshop choice:  

Please mail your check or money order for $150, payable to Kutztown University, to:

Kutztown University, Att. Susie Schmoyer, Dean's Office, College of Education
PO Box 730, Kutztown, PA 19530

Please submit registration form and payment by June 20, 2011.