Survey of Interest in Technology Workshop

1. Survey to Determine Interest in a Technology Related Worshop for Administrators and Key Leaders

There is an interest in hosting a workshop with either Alan November or members of his team. Alan is a world-wide speaker and leader in both technology and school leadership. You can view information about Alan November at Please complete this survey if your division has an interest in this workshop / topic. Completing the survey DOES NOT obligate you to participation. A memorandum of understanding will be developed if sufficient interest is found across the region.
1. Name of the School Division
2. Contact person for the workshop
3. E-mail Address for the Contact Person
4. Phone Number for the Contact Person
5. Fax Number for the Contact Person
6. Workshop Preference
First ChoiceSecond ChoiceThird Choice
Full Day (including lunch)
Full Day (exclude lunch
½ Day
7. Timing of the Workshop
First ChoiceSecond Choice
Spring (During the regular work week)
Summer (After June 15th)
8. Estimated Number of persons that Would Attend

9. Cost sharing method (Maximum Amount to be paid by division)
10. Cost sharing method (Maximum Amount to be paid by division per person)
11. Maximum Cost Per Division, if division charge is used instead of a per person cost
12. Other Comments
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