Teacher Registration Form First Name (required) Last Name (required) Date of Birth (required) Gender (required) ---MaleFemale Instrument for Teacher Training Course (required) Address (required) City (required) State (required) Zip Code (required) Your Email (required) Phone Number (required) SAA Membership Number Training Status (required) ---ParticipantAuditor If you are a high school student, what is your planned date of graduation? T-Shirt Size (included in tuition) (required) ---Adult - SAdult - MAdult - LAdult - XLAdult - XXL Please list previous Suzuki training. Include units covered, dates, instructors and institutes or workshops attended. TEACHER TRAINEE FEE PAYMENT - T-shirt, Sunday Pizza Dinner & Monday Cook-Out are included with any Unit registrations - No registration fee if registering for ECC only Registration Fee (non-refundable): $75Every Child Can! (June 8, 2017): $135Unit 1 (June 9-16, 2017): $655Unit 1 & ECC: $765SAA Course Registration Fee (unit 1): $15Unit 2 (June 8-12, 2017): $425SAA Course Registration Fee (unit 2): $15Unit 3 (June 12-16, 2017): $425SAA Course Registration Fee (unit 3): $15Units 2 & 3: $825Unit 5 (June 8-16): $425SAA Course Registration Fee (unit 5): $15 Number of Additional Pizza Dinners ($8 each) Number of Additional Ice Cream Social Tickets ($5 each) Additional T-Shirts ($15) - Please list Number and Size I have read and understand the Memphis Suzuki Institute Policies and I agree to abide by the regulations stated there. I accept complete responsibility for the charges and fees that may be incurred. Please note that you will not be able to submit the form without first checking the box above to accept our policies. You may view our policy by clicking on this link: http://suzukimemphis.com/policies/ Once you click the "Submit Form" button, we will receive your form for review. You will receive a PayPal invoice within 24 hours. The invoice will be sent to the email address you provided. Thanks!