Leadership Strands Registration 2008-09

First Name:	Middle Initial:
Last Name:
Prefix/Title:	Dr. Mr. Ms.
District:
Position:
School:
Address:
City:
Zip:
Office Phone:
Office Fax:
E-mail:	* Required

2008-09 Options:

Teacher as Leader Endorsement* Fee: Tuition (to Asbury College)

Aspiring Principal Cohort* Fee: $500 (plus tuition to Indiana University Southeast)

Principal Support Network Fee: $500

Cohesive Coaching Institute Fee: $300

* To apply for the Aspiring Principal Cohort or the Teacher as Leader Endorsement, contact the respective representative from Asbury College or Indiana University Southeast, as indicated.

Payment Options:

Check (Note: I have printed this form and mailed with my check to 154 Consumer Lane, Frankfort, KY 40601)

Purchase Order #

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Wayne Young, Executive Director
Rhonda Caldwell, Deputy Director
Shirley LaFavers, Director of Professional Development
Wanda Darland, Communications Specialist

152 Consumer Lane
Frankfort, KY 40601
(800) 928-KASA or
(502) 875-3411

Fax (502) 875-4634