West Virginia Center for Professional Development

West Virginia Center for Professional Development

2011 West Virginia Advanced Placement Summer Institute

Out-of-State Registration Form

Please fill this out completely.

Name:

First Name Preferred for Name Badge:

Home Address:

City, State, Zip:

Home Phone:

Email Address:

School:

School County:

AP Course Currently Teaching:

AP Course Planning to Teach:

Grade Level Currently Teaching:

Please include an email address that you check regularly. A confirmation will be sent to that address.

Check the session you will attend.

Tuesday, June 28 – Friday, July 1, 2011 – Capital High School, Charleston, WV

_____Art History _____Environmental Science

_____Biology (New) _____European History

_____Biology (Experienced) _____Human Geography

_____Calculus AB – Week One _____Physics B

_____Calculus BC _____Psychology

_____Chemistry (New) _____Statistics

_____Chemistry (Experienced) _____Studio Art

_____English Language (New) _____U.S. Government and Politics: U.S.

_____English Language (Experienced) _____U.S. History (New)

_____English Literature (New) _____U.S. History (Experienced)

_____English Literature (Experienced) _____World History

Tuesday, June 28 – Friday, July 1, 2011 – WVCPD Office, Charleston, WV

_____Computer Science A

Tuesday, July 19 - Friday, July 22, 2011 - University High School, Morgantown, WV

_____Biology (New) _____Human Geography

_____Biology (Experienced) _____Macroeconomics

_____Calculus AB – Week One _____Music Theory

_____Calculus BC _____Physics B

_____Chemistry (New) _____Psychology

_____Chemistry (Experienced) _____Spanish Language

_____English Language (New) _____Statistics

_____English Language (Experienced) _____Studio Art

_____English Literature (New) _____U.S. Government and Politics: U.S.

_____English Literature (Experienced) _____U.S. History (New)

_____Environmental Science _____U.S. History (Experienced)

_____European History _____World History

Tuesday, August 2 – Friday, August 5, 2011 – Braxton County Middle School, Flatwoods, WV

_____Art History _____Microeconomics

_____Calculus AB – Week Two _____Music Theory

_____English Language _____Spanish Language

_____English Literature _____U.S. History

_____French Language _____U.S. Government and Politics: U.S.

Fee Information

The registration for those teaching outside of West Virginia is $900.00. Lodging, breakfast, lunch, and College Board materials are included in this cost.

____ I have enclosed a check/money order/purchase order for $900.00 made payable to the West Virginia Center for Professional Development.

____I am faxing/emailing my registration form and my registration payments/purchase order will be sent through the mail.

Lodging

Lodging fees are included in the $900.00 registration fee, and we book all rooms.

I need lodging provided on the following evenings:

____Monday ____Tuesday ____Wednesday ____Thursday

Please mail, fax, or email form by June 3, 2011 to:

WV Center for Professional Development

Attn: Nikki Graybeal

208 Hale Street

Charleston, WV 25301

Fax: (304) 558-0989

Phone: 1-800-982-7348

Email:

If you have any questions, please contact Karen Linville, Director of Advanced Placement Programs at or 1-800-982-7348.