EVENT REGISTRATION School Climate Conference Registration Choose Conference for RegistrationSpring School Climate Conference | April 5-7, 2020Organization Name* Type*DistrictSchoolTribeCityNon- ProfitPolice DepartmentContact Name* First Last Phone*Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Conference RegistrationPlease identify the total number of participants to be registered. Also, list each participant who will be attending the conference. **If you are the contact person identified above for this form and you are also attending the conference, you need to include your information below as well. **Please note, ONLY THE CONTACT PERSON WILL RECEIVE CONFIRMATION EMAIL. Number of Participants*Please identify the total number of participants to be included in this registration form. If you are the contact person, please add your name below in the participants information.123456789101112131415161718192021222324252627282930Participants*Please enter the name and email address of each participant attending the School Climate Conference. Click the plus sign to the right to add participants. If you are the contact person, please add your name and information here also.First NameLast NameEmail AddressJob TitleSchool or Organization Optional: Post Conference Training RegistrationIf you are not registering for a Post Conference Training, Please Skip this Section. Choose an option below if you desire to attend the Post Conference Training Classes. To attend a Post Conference Training you must purchase either a My Journey Curriculum Set or an Annual Subscription to Direction Survey.Direction 101: Take Control of your Data!Direction Survey Annual Subscription will be added to your total Registration cost. Up to four conference participants may attend the training. Training class is April 7, 2020 - 1:00 p.m. - 5:00 p.m. Price: $295.00 Quantity: Grief Group Facilitating for K-12 Youth (Elementary Version)Choose this option if you would like to purchase the My Journey Grief Curriculum for Elementary School age Youth Up to four conference participants may attend the training. Training class is April 7, 2020 - 1:00 p.m. - 5:00 p.m. Price: $239.00 Quantity: Grief Group Facilitating for K-12 Youth (HS/MS Version)Choose this option if you would like to purchase the My Journey Grief Curriculum for High Schools and Middle School age Youth. Up to four conference participants may attend the training. Training class is April 7, 2020 - 1:00 p.m. - 5:00 p.m. Price: $199.00 Quantity: Payment TotalPayment Method:*Credit card payments are accepted.Credit Card or PayPalCheckConference Registration Total CostThis total cost reflects the number of participants are registering with this form. The cost Includes all socials, snack breaks, workshops, and general sessions. This total cost does not include Post Conference Training Options. Price: $0.00 Total - Conference Registration and Post Conference Training if Chosen.Checks and Purchase Orders payable to PCE Solutions. There are NO REFUNDS accepted. $0.00
