SLIS Continuing Education Registration Form

Simmons SLIS Continuing Education Registration Form

First Name
Last Name
Email
Organization
Job Title
Address Type

Address Type Home Work
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
For cost information please refer to our workshop page: http://alanis.simmons.edu/ceweb

For discount information, please refer to our workshop discount page: http://alanis.simmons.edu/ceweb/discounts.php
Student Type

Student Type Regular Registrant Simmons SLIS Alum Simmons SLIS Student FLO Affiliate
If Simmons SLIS Alum, please enter year of graduation
For each workshop, please select the title and the applicable Full, Simmons SLIS alum, or Simmons SLIS student cost below
Workshop 1
Workshop 2
Workshop 3
Workshop 4
PDPs

Do you need professional development points (PDPs) used for recertification at the Department of Education? For more information, please see http://alanis.simmons.edu/ceweb/faq.php#ceupdp
PDPs?

PDPs? Yes
Area of Certification
How did you hear about the SLIS Continuing Education Program?
Please Choose:
If other, please specify:
Payment Method
Notes