TOT Registration Form
Print and complete the form below to register for the
2008 Michigan Model for Health® Training of Trainers. 
The training is limited to twenty five participants.
Please mail or fax this registration form to:
    Educational Materials Center (EMC)
    139 Combined Services Building, CMU
    Mt. Pleasant, MI 48859 
    FAX: 989-774-3943
 return to TOT page

Registration Deadline is June 1, 2008
____ I want to register for the July 21-25 Training of Trainers for Grades K-5
____ Enclosed is my payment/purchase order for $___________. ($900* per participant)
____ Payment or a purchase order will be mailed.  I understand that my registration is not confirmed until payment is received by the EMC.
 


Name:__________________________________________

School/Organization: _______________________________

Address: ________________________________________

City/State/Zip: ____________________________________

Telephone: (        ) _________________________________

FAX:  (       ) ______________________________________

e-mail address: ___________________________________

Telephone number during summer months: 
(       ) ____________________________

Special Diet requirements __________________________ (i.e. vegetarian, food allergies, etc.)
   
*Registration fee includes training, training materials, trainer's toolkit on CD, continental breakfast, lunch and snack each day of training.  Individuals are responsible for all other meals, lodging and travel.

Copyright 2008

Educational Materials Center
Last revised: April 02, 2008