Negotiations Su05 - Registration Form

REGISTRATION FORM - Summer 2005

"EVERYTHING IS NEGOTIABLE"
for Superintendents, Building Administrators, and Board Members.
For all members of the district’s negotiations team

Check one: Choose from Four Locations

___ Southern Tier New York - Thursday, July 21, 2005 - 9:00 AM to 3:00 PM (Noon lunch)
        Steuben-Allegany BOCES - Bath H.S. Conference Site - Bath, New York

___ Western New York - Friday, July 22, 2005 - 9:00 AM to 3:00 PM (Noon lunch)
        Clarence High School - Conference Room - Clarence, New York

___ North Eastern New York - Thursday, July 28, 2005 - 9:00 AM to 3:00 PM (Noon lunch)
        Best Western Inn at Smithfield - Plattsburgh, New York
                 Co-Sponsored with the Adirondack Chapter NYSASBO

___ North Central New York - Friday, July 29, 2005 - 9:00 AM to 3:00 PM (Noon lunch)
       Jefferson-Lewis BOCES - Conference Room - Watertown, New York

NAME OF SCHOOL DISTRICT: _____________________________________________

ADDRESS: ___________________________C/S/Zip:_________________________________

TELEPHONE: ( ) _________________ FAX: ( ) _____________________

NAME OF PARTICIPANT: _________________________ / _________________

        _________________________ / __________________________

        _________________________ / __________________________

Cost - The cost of the workshop is $300 for one person. $250 per participant for the second and subsequent participants from the same school district. The workshop is BOCES aidable through COSERs 504 and 512 - direct or through cross-contract with the Steuben-Allegany BOCES.

TOTAL AMOUNT: $ __________

Check one: METHOD OF PAYMENT

____ Check # _______ or purchase order # _______ to "Steuben-Allegany BOCES" (enclose)

____ Please bill through my BOCES on cross-contract with the Steuben-Allegany BOCES, COSERs 504 and 512 as follows:

Name of BOCES: _________________________________________

NOTE: School districts who are not components of the Steuben-Allegany BOCES must send a written request to their BOCES District Superintendent requesting a cross-contract for Coordination COSERs 504 and 512.

Superintendent's Signature: _________________________ Date: __________

FAX to (716) 672-5472, then Mail to:
Dr. James M. Merrins, Program Administrator; Steuben-Allegany BOCES
Superintendent Support Programs, 42 Rosalyn Court; Fredonia, NY 14063

QUESTIONS: State Office (716) 672-5473

Or on the web at: www.SuperintendentOfSchools.com