Women Administrators Professional Development
REGISTRATION FORM - Spring 2017 Series
"Women in Leadership: Reflections From a Longitudinal View"
Buffalo - Rochester - Syracuse - Albany
NOTE 1: You will receive an e-mail confirmation of date, times, location, and payment information; and by FAX (if you provide) or postal mail.
NOTE 2: You / Your district will be invoiced after the session.
Choose from Four Locations - 4:00 AM to 7:30 PM
Western New York – Tuesday, May 16, 2017
Salvatore’s Restaurant, Depew (Buffalo area), NY
Mid-Western and Finger Lakes New York – Wednesday, May 17, 2017
Burgundy Basin, Pittsford (Rochester area), NY
Central New York –Tuesday, May 23, 2017
Double Tree by Hilton, Syracuse (Carrier Circle), NY
Eastern New York – Wednesday, May 24, 2017
Holiday Inn Express, Latham (Albany area), NY
The cost of this program is $95 per participant, includs dinner.
QUESTIONS: Contact Jim Merrins, Ed.D. (716) 672-5473 firstname.lastname@example.org
Western New York - Depew (Buffalo area), NY - May 16, 2017
Mid-Western New York - Pittsford (Rochester area), NY - May 17, 2017
Central New York - Syracuse (Carrier Circle), NY - May 23, 2017
Eastern New York - Latham (Albany area), NY - May 24, 2017
Select a Payer (We will invoice)
School District paying for this Professional Development Event
Individual paying for this Professional Development Event
Name of School District OR Individual Paying
Billing - Street Address
Billing - City / State / Zip Code
FAX number (for fast confirmation)
Preferred E-mail Address
Name of first participant - $95
Title of first participant
Name of second participant - plus $95
Title of second participant
Names and titles of additional participants - plus $95 each
The cost of this workshop is $95 per participant.
Enter the total dollar amount HERE
Make check or purchase order payable to "NYSAWA" (EIN 14-1805715) and noted as “ELI - Women Professional Development”
Mail Check or Purchase Order to:
NYSAWA at NYSSBA
Ellen Kramek, Registrar
24 Century Hill Drive
Latham, NY 12110-2125
IF YOU HAVE PAYMENT OR BUSINESS QUESTIONS: (518) 783-3753
Check or Purchase Order Number (if know at this time)
May be provided later.
Special Notes - Please let us know anything special about your registration, such as, this is a make up, or you have special needs, etc.
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