Event Registration

Event:
Event Date:
Event Add'l Dates:

Please Enter the Required Information below.
 
First Name:  
Last Name:  
Job Title:
Email Address:  
Alternate Email:     
Phone Number:(999-999-9999)        
Alternate Phone:(999-999-9999)     
School/Organization:


Preferred Date/s to Attend: Click to select multiple dates or Click all :
Event Strands:
Site Coordinator's name:  
Site Coordinator's email:  
 
CANCELLATION POLICY:
If the workshop is cancelled by SJCOE, enrollees will be notified in advance and will obtain a full refund. No refunds will be given for participant cancellations.
 
Payment Methods Accepted
**NO PURCHASE ORDERS ACCEPTED**
_____Check (payable to SJCOE)
_____District Journal (San Joaquin County Districts ONLY-contact your District Business Office)
 
Remit Payment to:
San Joaquin County Office of Education
Dept: AVID
Attn: Frances Deane
P.O. Box 213030
Stockton, CA 95213-9030 		To Journal Remit to:
Program/Dept: AVID/Educational Services
Revenue Account Code:
01-9010-0-0000-0000-8689-700-6299
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