Instructional Leadership Directors’ Roundtable Checkout

Instructional Leadership Directors' Roundtable Registration

Product Name
Name of person handling registration*

First

Last
Email of person handling registration*
Phone number for person handling registration*
Organization*
Student enrollment: (enter number)*
Total
$0.00
Name(s) & Email(s) of Roundtable registrant(s)*

Note: Your membership includes any principal supervisors and senior leaders in your organization. Do not include principals, APs, or other staff—we will contact you for a list and develop a rollout plan.

Please list the name and email address for each person you would like to participate directly in the Roundtable. If you prefer, you can just list one person for now, and add more later at no charge.

Shipping address for books and other welcome materials:*

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country

Payment Method

Credit Card

Purchase Order/Check

Credit Card

The Stripe Card field cannot work when the Payment Collection Method is set to Stripe Payment Form (Stripe Checkout).