DLS Workshop Registration Form
Register early! Seating is limited.
Must register at least 15 days prior to workshop date. Late registrations add 10% to total cost.
Enroll me in the following Davis Learning Strategies® 2-day Workshop:
Date: ____________________________________________________
Location: _________________________________________________
Enclosed is my payment of $595 payable to DDAI: (all prices in US Dollars)
¨ check ¨ credit card ¨ School District Purchase Order:#_________________
Credit Card: ¨ Visa ¨ MasterCard ¨ Amex ¨ Discover
(Please Print Clearly)
Number ________-_________-________-________ Expiration Date: ____/____
Name as it appears on card
Signature:__________________________________________________
¨ Send me information on registering for Academic Units or CEUs.
Send my receipt, advance study materials and confirmation to:
Name_______________________________________________________
Address_____________________________________________________
City_____________________ State/Province/Country______________
Postal Code_______________
Phone: (____)___________Alternate phone: (____)________________
E-mail: _______________________________________________________
Cancellation and Refund Policy:
All payments are fully transferable to alternate workshop dates. A $65 administrative fee is deducted from all refund requests. Workshops may be subject to cancellation if minimum enrollment requirements are not met, in which case, a full refund will be made.
MAIL to 1601 Bayshore #260, Burlingame, CA 94010 or
FAX to (650) 692-7075 or
CALL 1-888-805-7216 (toll-free) to register by phone