Teacher's Workshop

/ Graduate Course / /

Differentiated Instruction for Every Classroom, Sunday thru Tuesday, November 7-9, 2004, Sheraton Music City Hotel, Nashville, Tennessee

Registration Form

(For room reservations, please call the Sheraton Music City Hotel at 615-885-2200.)

To register, simply print out and complete this form and fax or mail it in with your check or purchase order to:

The Teacher's Workshop 1250 Overlook Ridge, Bishop, GA 30621 1-800-991-1114 Fax: 706-769-4137

CREDIT CARD REGISTRATIONS: The great majority of our customers register with a check or with a copy of their purchase order submitted along with the registration form. We are also happy to accept your VISA or Mastercard payment. However, we cannot accept your credit card from our website. Please add your credit card number and expiration date to the completed registration form and fax to us at (706) 769-4137; or you may prefer to call us at (800) 991-1114.

Name:  ______________________________________________________
Title:   ______________________________________________________
School/District:   ______________________________________________________
Address:   ______________________________________________________
City:   _____________________State: ___________ Zip: ____________
Phone:   ______________________________________________________
Fax:   ______________________________________________________
Email:   ______________________________________________________


Full Conference



$289.00  ________________________________ ______________________
One Day Registration  
$179.00  ________________________________ ______________________

1 Semester Hour - $89

 ________________________________ ______________________
* Conference Materials Kit at a over 16% Discount $99.95 (see below) ________________________________ ______________________


 ________________________________ ______________________
Cancellation Policy: We encourage substitution rather than cancellation. If a substitute is not possible, all cancellations must be made in writing via fax or mail (postmarked) by Friday, October 8, 2004. A full refund less a $50 processing fee will be given. Cancellations received or postmarked after October 8, 2004 will not be refunded (this includes "no-shows" for the conference).

/ Graduate Course / /

* Conference Materials Kit consists of 4 books: Differentiating Instruction in Math (Bender), Differentiated Instructional Strategies: One Size Doesn't Fit All (Chapman), Differentiation for Gifted and Talented Students (Tomlinson), and Essential Ingredients: Recipes for Teaching Writing (Worsham).