Transformative Storytelling: Professional Development Training for Teachers Registration Transformative Storytelling: Professional Development Training for Teachers 2023 Transformative Storytelling Registration 2023 FORM Name(Required) Participant’s First Name Participant’s Last Name Participant's Contact Email(Required) (used for updates, confirmations, materials, and parking information, if different from school email) Participant's Cell Phone #(Required)School District(Required)School Name(Required)Grade Level(Required)(classroom teacher, curriculum director, administrator, including grade level)Scholarship Information*Scholarships for 60% off Workshop Fees are available to educators working in districts where 50% or more of students qualify for reduced or free lunch. Untitled Check here if you are eligible for a Scholarship Friday, March 31, 9:00-11:30am: The Brain on Story Quantity Price: $125.00 Quantity Friday, March 31, 9:00-11:30am: The Brain on Story Quantity Price: $50.00 Quantity Friday, March 31, 1:00–3:30pm: Storytelling to Meet NJSLA and Educator PD Standards Quantity Price: $125.00 Quantity Friday, March 31, 1:00–3:30pm: Storytelling to Meet NJSLA and Educator PD Standards Quantity Price: $50.00 Quantity Saturday, April 1, 9:00-11:30am: Reclaiming Student and Community Stories Quantity Price: $125.00 Quantity Saturday, April 1, 9:00-11:30am: Reclaiming Student and Community Stories Quantity Price: $50.00 Quantity Saturday, April 1, 1:00-3:30pm: Stories That Matter: Building Cultural Equity thru Story Quantity Price: $125.00 Quantity Saturday, April 1, 1:00-3:30pm: Stories That Matter: Building Cultural Equity thru Story Quantity Price: $50.00 Quantity Friday, April 14, 9:00-11:30am: Cross-Curricular Storytelling to Rebuild Communication Skills Quantity Price: $125.00 Quantity Friday, April 14, 9:00-11:30am: Cross-Curricular Storytelling to Rebuild Communication Skills Quantity Price: $50.00 Quantity Friday, April 14, 1:00-3:30pm: A Story in Every Song, A Song in Every Story Quantity Price: $125.00 Quantity Friday, April 14, 1:00-3:30pm: A Story in Every Song, A Song in Every Story Quantity Price: $50.00 Quantity Total Amount Due Payment Method(Required) Credit Card Check (Please select one)Please Mail Payment for calculated total to: Storytelling Arts Att: Linda Helm Krapf P.O. Box 157 Stockton, NJ 08559Credit CardCard Details Cardholder Name PHOTO/VIDEO RELEASE STATEMENT & PERMISSION(Required) I agree to the below policy By checking this box, I hereby grant permission to the rights of my image, likeness and sound of my voice as recorded on audio or video tape without payment or any other consideration. I understand that my image may be edited, copied, exhibited, published, or distributed and waive the right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of my image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographic area. Photographic, audio or video recordings may be used for the following purposes: • conference presentations • educational presentations or courses • informational presentations • on-line educational courses • marketing and promotion • educational videos. By checking this box, I further understand this permission signifies that photographic or video recordings of me may be electronically displayed via the Internet or in the public educational setting. I will be consulted about the use of the photographs or video recording for any purpose other than those listed above. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. This release applies to photographic, audio or video recordings collected as part of the sessions listed on this document only. By clicking this box, I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against Storytelling Arts, Inc. and any person utilizing this material for educational purposes.If your school requires a Purchase Order, please contact Linda Helm Krapf 609-430-1922 or Linda@storytellingartsinc.org