CHCI's Education Policy Summit Registration Form

Date: Monday, May 21, 2012
Time:  3:00 until 7:00 pm
New World Center - Main Performance Hall
500 17th Street
Miami Beach, FL 33139
Attire: Business

To confirm your attendance at Education Policy Forum, please complete the following registration formIf you are interested in sponsoring or participating in the Ready to Lead event in Miami on May 19, please contact Marie Hughes at 202-548-5873.

Full Name * 
Title * 
Company/Organization * 
Email Address * 
Phone Number 
By registering for this event, I agree to be photographed or videotaped for possible use in CHCI publications and other printed or online marketing materials. Enter "YES" (case-sensitive) to agree. * 
Pursuant to the Americans with Disabilities Act, please let us know if you require any specific aids or services at this event. 
* Required

For questions regarding this or future events, please contact:

Saúl Peña, Education Consultant, at or 202-365-8389.

Thank you to our event partners and generous sponsors:

Miami Education Forum Sponsor Block