Behavioral Institute for

Children and Adolescents

MIEBD 2008 Summer Institute Registration

Session I   July 28 - Aug. 1

Session II  Aug. 4-8


Please submit one registration form per attendee. If you prefer to mail or fax a registration form, you can download a pdf version of the registration page.

Please provide the following contact information:

First Name
Last Name
Please type your full name as you would like it to appear on badge/certificate
Gender Male Female
Organization/District
Home Address
City
State/Province
Zip/Postal Code

Work Phone

(format xxx-xxx-xxxx)

Home Phone

(format xxx-xxx-xxxx)

FAX

(format xxx-xxx-xxxx)

E-mail
Confirm E-mail:

UNIVERSITY/COURSE SELECTION

All participants (except CEU only) are required to register for Fall semester graduate credit through a participating University (note: U of M Duluth SpED 5382 is for Spring 09 registration). Please indicate your selections:

 

   Session I:  July 28 - Aug. 1

            Characteristics of EBD

                    University Selection 

            Advanced Seminar I

                   University Selection 

 

   Session II: Aug. 4-8

            Behavior Management

                    University Selection 

            Advanced Seminar II

                   University Selection 

 

LODGING

The Institute includes double occupancy accommodations at the Four Points by Sheraton hotel for participants traveling more than 50 miles. If you do not indicate a roommate preference, a roommate will be assigned. If you wish to have single accommodations, you will be responsible for paying 50% of the room fee (approximately $54 per night). Please indicate your hotel needs:

    Please provide Session I accommodations for me on the nights of July 27, 28, 29, 30, 31

        Roommate preference:

    Please provide Session II accommodations for me on the nights of Aug. 3, 4, 5, 6, 7

        Roommate preference:

    I do not need hotel accommodations

 

COST

There is a $30 non-refundable registration fee per class (payable to B.I.C.A.). Students who attend each class session will receive a $30 coupon toward the purchase of discounted professional materials at the end of the week. Students must also REGISTER at their selected university and PAY TUITION to receive credits.

 

To activate your registration, please mail a check ($30 for one course or $60 for two courses) to:

BICA

3585 Lexington Ave. N, Suite 163

Arden Hills, MN  55126

 

Check #

Amount $

 

SPECIAL NEEDS

Please indicate any special needs or meal requests:

 

MORE INFORMATION

Contact Melissa Knoll at 651-484-5510 or via email

 

 

The Institute is coordinated by the Behavioral Institute for Children & Adolescents (BICA) and it is part of MIEBD, a multi-agency institute established by the Minnesota Department of Education (MDE) to provide a full continuum of support to new and continuing teachers of students with EBD. This initiative was made possible through a grant from MDE from the federal award, Special Education-State Personnel Development Grant of P.L. 108-466 IDEA and CFDA 84.323A.

 

THANK YOU!


M. Knoll
Copyright © 2008 [Behavioral Institute for Children and Adolescents]. All rights reserved.
Revised: 05/01/08