KMIC Mentor Training Pre-Registration

COVID-19 Updates from WSU

COVID-19 Status: LIMITED OPERATIONS

In response to the COVID-19 pandemic, Wichita State University will conduct all classes online or remotely for the summer.

For COVID-19 updates and information, go to wichita.edu/covid19news.

KMIC Mentor Training Pre-Registration

School districts can pre-register participants, by submitting a purchase order number acknowledging the $500 member fee and the number of participants attending, with estimated amount. This Pre-Registration Form will be followed up with a contract and additional individual registration link information for final registrations.

All final registrations must be completed by August 1.

For questions, please contact KMIC Director, Sherry Goodvin at (316) 978-3385 or sharon.goodvin@wichita.edu.

If you see this don't fill out this input box.

School District USD#*

District Contact Name*

District Contact Phone*

District Contact Email*

Street Address*

City*

Zip Code*

Registration Fees

$500 district membership
$650 per mentor for online training
$850 per mentor for hybrid training

Total Number of Year 1 Hybrid Participants @ $850 each

Total Number of Year 1 Online Participants @ $650 each

Total Number of Year 2 Hybrid Participants @ $850 each

Total Number of Year 2 Online Participants @ $650 each

Total Number of Participants *

Estimated Total (include $500 district membership fee)*

Purchase Order Number*

Billing Contact Information

Billing Name*

Billing Address*

Billing City*

Billing Zip Code*

Billing Email Address*