Texas Caucus of Black School Board Members (TCBSBM)

Event Registration Form ________(2012 Educational Summit)

Use the online form on this page to register for our 4th Annual Texas Caucus of Black School Board Members (TCBSBM) Educational Summit. Ensure payment is received by February 28, 2011 either by mail or online through PayPal. The pay options will follow this page once you complete the registration form.

A). Steps to Register:

1). Step one fill out the form seen below ("Event Registration Form"....this is to provide us with your information in case we need to contact you).

2). Step two is to choose a pay option (either pay online or mail payment). Please assure you pay for the correct number of individuals attending the summit. This number should correlate with the list of attendees on this page.

_Event Registration form (must be filled out whether paying by mail or on-line):

Name:

Email:

Phone#:

School District:

Others Attending:

Attendee 1 Name:

Attendee 2 Name:

Attendee 3 Name:

Attendee 4 Name:

Question or Comment:

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