Cambridge School Improvement Workshop Registration Form

Mail/fax to Cambridge, 2720 River Rd #36, Des Plaines, IL 60018; Fax: 847-299-2933
 


 
Name/Title   Name/Title
     

 
School   School
     

 
Address   Address
     

 
City/State/Zip   City/State/Zip
     

 
Phone/Fax   Phone/Fax
     

 
Workshop Location Attending   Workshop Location Attending

Registration Fees:
Number of non-profit registrants _____ x $35.00 (or 3 for $100)
Number of for-profit registrants _____ x $250.00
Total $ ___________

Payment Options: Please check next to the appropriate option.
Registration deadline is one week; three-day advance cancellation required.

____ No fee applies (Current Cambridge Partner Instituation)

____ Check/Money Order enclosed (made payable to Cambridge)

____ Purchase Order #: _____________________________

____ Charge to Credit Card (Visa/MC only) Card #: _____________________ Exp. Date ______
          CVV Number (last three digits on back of card) __________