Register for SEMI

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Name of Training*

Dates of Training*

Location of Training*

Trainers*

Name as it appears in ELMS*

First Middle Last

Hidden

Event Date

Educator ID (found at the bottom corner of your MS Educator License)

Email Address*

Address*

Street Address Address Line 2 City State ZIP Code

School District Employed

School Where You Teach

Phone

School or personal phone.

Today's Date

Signature

Typing your name in this box represents your signature.

Event Date*

20% discount ends July 1, 2022. Registration is $420 after July 1.

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Credit Card

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Card Number Expiration Date Security Code Cardholder Name

P.O. Number

* to be eligible for SEMI credit, must have a standard career-level administrator endorsement on your MS educator License.

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