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Register For a Discipline With Purpose Workshop

I would like to register for a 2012 workshop:

.

____July 30-31, 2012 - Basic Training - Elkhorn, NE
____Aug. 1-2, 2012 - Basic Workshop - Phoenix, AZ ____Aug. 3, 2012 - Graduate Day - Phoenix, AZ
• 3 Hr. Online Graduate Credit class from Peru State University to begin March 12, 2012 and run through May 4, 2012. See additional information under College Credit.

Name: ____________________________________________________

Address: _______________________City: ____________St. ________

Zip: ________________________  Phone (          )________________

School: ______________________ Position  _____________________

Email: ____________________________________________________

As part of the workshop fee I would like to receive lesson plans for: (circle one)
* Pre-school + Kinder * Gd 1 * Gd 2 * Gd 1/2 Rel. Ed.  
* Gd 3 * Gd. 4 * Gd 3/4 Rel. Ed. * Gd 5 * Gd 6
* Gd 5/6 Rel. Ed. * Gd 7 * Gd 8 * Gd 7/8Rel. Ed * Computer
* Admin. * DWP Committee Booklet * P.E. * Media/Childs Lit * Parent
* Marching Into Music * Art Packet * Anti-Bullying Curriculum * DWP Grad
(Will bring binder)
* Study Skills

Specialist/other____________________________________________

Check enclosed for
____ $225 for one person
____ $205 for two or more "from the same school"
____ $170 if no lesson plans ordered
____ $65 for DWP Grads
____
$100 for Grads attending who need new materials.
____ Send directions
____ Hotel suggestions
____ Info about graduate credit

Credit cards for this workshop are accepted.

Item 1000-225
Workshop fee for one person. $225.00

Item 1000-195
Workshop fee for two or more. $205.00

Item 1000-160
Workshop fee if lesson plans have been purchased previously. $170.00

Item 1000-155
$65 for Graduate Day or a DWP Graduate attending the workshop for a second time

Item 1000-95
$100 for Graduate attending either the Graduate Day or Workshop and would like
to receive new lesson plans or materials.

Mail completed form at least 3 weeks prior to the scheduled workshop to:

Discipline With Purpose, Inc.
117 Woodland Circle
Reedsville, PA 17084
1-800-691-4DWP(4397)
1-717-667-3451
Fax - 717-667-6554
E-Mail DWPBV@aol.com


© Discipline with Purpose • 117 Woodland Circle • Reedsville, PA 17084 • 1-800-691-4397 • 1-717-667-3451 • FAX 1-717-667-6554  • Email