Summer Teacher Institute Registration

July 8 - 12, 2013

(Monday, 1:00pm-5:30pm, Tuesday through Thursday, 8:30 AM - 5:30 PM, Friday 8:30 AM - 1:00 PM)

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REQUIRED:

Complete and submit this form online. Do not submit payment until online form is completed.
If you are paying by check or money order, mail Summer Teacher Institute registration fee of $250 (personal check or money order) payable to: Rock and Roll Hall of Fame and Museum. Please write "Summer Teacher Institute" in the memo line.

Mail to:
Rock and Roll Hall of Fame and Museum
ATTN: Barb Cunningham -- Accounting
1100 Rock and Roll Boulevard
Cleveland, OH 44114-1022

If paying with credit card, after submitting online form, download the STI credit card payment form in either Word or PDF format. Fax completed STI credit card payment form to 216.515.1931 or mail it to the above address.

Only adults may register.

Refunds: The Rock and Roll Hall of Fame and Museum will provide a full refund for Summer Teacher Institute registration cancellations, provided that written notice of the cancellation (with receipt of confirmation) is received at least twenty (20) business days prior to the start of the Summer Teacher Institute. Under no circumstances will the Rock and Roll Hall of Fame and Museum provide a partial refund for non-attendance OR when written notices of cancellation are received less than twenty (20) business days prior to the start of the Summer Teacher Institute.

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All fields that are in bold are required.

First Name

Last Name

Address

Second Line

City

State

County

Country

Postal Code

email address

Years Teaching

Sex

Home Phone

Work Phone

School Affiliation

School District

Current Grade Level

Primary Area(s) of Instruction

Other Disciplines/Teaching Interests

Highest Degree Earned

Name of College/University

Mo/Yr of Graduation

How did you learn about the Institute?

To choose more than one field, hold down CTL (or command) and click on each item.

Payment Method

If you are paying with a credit card, be sure to download the STI credit card payment form found above and fax to 216.515.1931.

Please indicate appropriate price point

Remember that your payment must be postmarked or faxed by each date in order to be elegible to pay that price point.

I need an invoice emailed to me to show to my school or granting institution.

If YES, please indicate school mailing address:

We will email an invoice to you, but our accounting department needs your school's address for their records.

Do you certify that you are an adult aged 18 years or older and agree to pay the Summer Teacher Institute Registration Fee to the Rock and Roll Hall of Fame and Museum?

Check here if you are interested in registering for optional graduate credit

I understand that STI REGISTRATION is on a first come, first served basis.

I understand that Registration will be confirmed upon receipt of payment and completed form.

I understand that, to complete the STI Registration process, I need to mail a personal check or money order of the appropriate registration fee payable to Rock and Roll Hall of Fame and Museum.

I agree to share my name, email, subject area with other participants in the interest of continuing dialogue after the Institute.