Summer Institute Registration

WSSB Summer Institute Registration 2019

Name *

Home Phone

Cell Phone

School District

Address

Country

City

State

Zip code

Email (1 Email address only) *

Your Role

Are you using personal funds to pay for this Institute?

Is your school district paying for you to attend this Institute?

Will you be using a combination of personal funds & school district money to pay for this Institute?

Do you receive professional development funds?

Are you being reimbursed for per diem or mileage?

Are you receiving additional money from any other sources to pay for this?

Institute limited to 50 Participants * Registration deadline July 1, 2019

If you need interpretive services or other accommodations please contact us by June 15, 2019

Mail $395 payment to:

Washington State School for the Blind – Summer Institute
Attn: Amanda Pizzo
2214 East 13th Street
Vancouver, Washington 98661 or
Fax to 360-737-2120

For more information call Pam Parker at: pam.parker@wssb.wa.gov