registration form teach like a pirate wednesday, april 22 ...€¦ · teach like a pirate join new...

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Registration FormTeach Like a Pirate

Wednesday, April 22, 2015

Name: __________________________________

School: _________________________________

School Address: __________________________

City: ___________________________________

State: _____________ Zip code: _____________

School Phone: ___________________________

School Fax: _____________________________

Email Address: ___________________________

Home Address: __________________________

City: ___________________________________

State: _____________ Zip code: _____________

Home Phone: ___________________________

Cell Phone: _____________________________

Grade level(s) I teach: ____________________

Payment MethodCost: $125

(Continental breakfast provided; lunch on your own)

m Check payable to Middlesex County College – Office of School Relations

m American Express m Master Cardm Visa m Discover

Exp. Date: __________ / __________ / _____ ___

Credit Card #: _____________________________

Signature: _________________________________

Purchase Order # (include district name):

__________________________________________

Wednesday, April 22, 2015

Fax registration to Office of School Relations

at 732.906.7709

Or mail to:

Middlesex County CollegeOffice of School Relations

Billy Johnson Hall, Room 2002600 Woodbridge Avenue

Edison, NJ 08818

For more information please call or email732.906.2554

schoolrelations@middlesexcc.edu

Teach Like aPIRATE

Teach Like a PIRATEJoin New York Times Best-Selling author Dave Burgess for a high-energy, entertaining and inspirational program that will transform the way you look at your role as an educator. Learn how to dramatically increase student engagement, design wildly creative lessons, and build a course that is a life-changing experience for your students.

Using a unique combination of magic and humor, he will reignite your passion for the education profession and show you exactly how to make school an amazing place that has students wanting to knock down the walls to get in.

Teach Like a Pirate has sparked a full-scale revolution in the educational world and has inspired teachers from all over the globe to achieve new levels of excellence in their schools and classrooms. This program is your chance to experience the one-of-a-kind presentational style of unbelievable intensity and outrageous energy that has transfixed audiences at packed venues across the nation.

Agenda8-9 a.m. Registration and continental breakfast

9 a.m.-Noon Teach Like a Pirate Professional Development Session

Noon-12:30 p.m. Lunch (Bring your own lunch)

12:30-3 p.m. Teach Like a Pirate Interactive Session

Facilitator: Dave BurgessDave Burgess is a teacher from San Diego, California and a professional magician specializing in stand-up comedy magic. He was the recipient of the national 2014 Bammy Award for Secondary School Teacher of the Year, the 2001 and 2012 Golden Apple winner in the Grossmont Union High School District and the 2007-2008 Teacher of the Year at West Hills High School. He has been voted a faculty standout for 17 consecutive years in categories such as Most Entertaining, Most Energetic and Most Dramatic. He specializes in teaching hard-to-reach, hard-to-motivate students with techniques that incorporate showmanship and creativity. He is the New York Times best-selling author of Teach Like a PIRATE that has sparked an educational revolution all over the world.