OUTREACH Online Registration Form 

Getting That First Job

Select: date / location:

Registrant Name:

First Name 
Last Name 
School District
School Address
City/State/Zip
School Telephone
Fax
E-mail
 

Billing Information, if different from above:

Name 
School District
School Address
City/State/Zip

Workshops start at 9:00 a.m. and will conclude with lunch 3:30 p.m.
The registration fee is $130 for MAESP members and $155 for non-members.

Please select your membership category:

I am a member of: 

Method of payment:

Check #
Purchase order #
Credit Card: If you wish to pay by credit card (Mastercard or Visa), please complete this enrollment form, click submit and then call MCSA OUTREACH at 573-638-2653 to insure confidentiality of your credit card information.

Make checks payable and remit to:
MCSA OUTREACH
3550 Amazonas Drive
Jefferson City, MO 65109-5716

Cancellation Policy:
Workshop registration cancellations will only be accepted in writing, by fax or e-mail 72 hours (three business days) prior to the event. Any cancellations received after that date will be subject to the full registration charge. ALL cancellations will be subject to a $20 administrative charge. No shows will be charged the entire registration fee.

Please note: Confirmation of this registration should be received within 10 days following submission. If not received, please call the MCSA OUTREACH office to confirm receipt of this electronic registration.

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To Contact MCSA OUTREACH:
Carole Kennedy, Director OUTREACH
Stephanie Sappenfield, Administrative Assistant
MCSA OUTREACH
3550 Amazonas Drive
Jefferson City, MO 65109

Phone:  573-638-2653
Fax:  573-556-6270
E-mail:  outreach@mcsa.org