MMS Workshop Registration Form

MMS Workshop Registration
Use the "Print" command in your browser to print this form. See below for mailing instructions.
Please complete a separate form for each person. Click here for fee details.

Name ______________________________________________________________

Address ____________________________________________________________

City ____________________________________________________ State _____ ZIP __________

Home Phone _____________________________ Work Phone _______________________________

Please check all that apply:

Montessori Teacher: Infant _____Toddler _____ 3-6 ____6-9 ______ 9-12 _____ 12-15 _____15-18 _____

Intern _____, Assistant/Aide _____, Parent _____, Administrator _____, Other ______

School with which you are associated: _______________________________________________________

Address _______________________________________City _____________________________ ZIP_________

E-mail Address________________________________________________________________________________
Please note: The Michigan Montessori Society will be providing most communication in electronic format.
Your e-mail address is essential in the future. We will not share or distribute your address in any way.

Membership:

I would like to become a member of the Michigan Montessori Society. Enclosed is my $15 membership fee.

Name ______________________________________________________________________

Address ____________________________________________________________________

City ________________________________________________ State _____ Zip ___________

Home Phone _______________________________ Work Phone _________________________

Do we have permission to publish your name, address, phone number and email in the MMS directory? Yes ____ No ____

Payment:

Make checks for workshop and/or membership fees payable to Michigan Montessori Society. Please send check(s) and
registration form(s) to: MMS, 466 N. John Daly, Dearborn Hts., MI 48127 Attn: Seminar Registration