2012 Evaluation Workshop at Montclair State University

 
1. Registrant Information:
*
2. My job title is:
3. Which of the following describes the evaluation carried out by your organization? (check all that apply)
4. Does your job require you to conduct program evaluation?
5. Are you in a position to determine whether and what kind of evaluation will be conducted within your organization (which may include determining allocation of resources to evaluation)?
6. How would you characterize your evaluation background?
7. What is your primary goal in attending this conference (i.e. what are you hoping to gain?)
8. Is there anything else you’d like us to know?
*
9. Are you an alumnus of Montclair State University?
10. If Yes, please indicate the most recent year you graduated and your program/major.
BEFORE HITTING THE "NEXT" BUTTON BELOW, PLEASE PRINT OUT THIS PAGE SO THAT YOU MAY MAIL THE PRINTOUT TO COMPLETE YOUR REGISTRATION.

Please include a check or money order (see fee schedule below) made payable to Montclair State University and mail to:

Ms. Tina Seaboch
Center for Research & Evaluation on Education and Human Services
UN3124
Montclair State University
1 Normal Avenue
Montclair, NJ 07043

Forms and payment must be postmarked NO LATER THAN September 25, 2012. If you have any questions, please email Ms. Seaboch at seabocht@mail.montclair.edu


WORKSHOP FEE SCHEDULE (includes tuition, materials, continental breakfast, lunch, and parking):

Postmarked by August 30:
$200 individual registration
$125 for each additional individual from the same organization

Postmarked between August 31 and September 25:
$ 250 individual registration
$150 for each additional individual from the same organization


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