Complete name of your district or governing body, no abbreviations please.

Complete name of your school, if applicable, no abbreviations please.

List the name you commonly use.

List your job title or position.

JaneDoe@abcschool.org - pre-reading and digital books will be emailed to this address.

Work or personal address where you would like to receive course materials.

602-123-4567 - this helps us contact you in case of an email glitch.

Person who will sign your curriculum licensing agreement on behalf of the district/organization.

Person who will sign your curriculum licensing agreement on behalf of the district/organization.

List the name of the person sending the PO or responsible for payment.

Email of the person sending the PO or responsible for payment so we can send an invoice.

602-123-4567 - this helps us contact them in case of an email glitch.

Purchase Order Number. Send PO to info@koi-education.com. Registration is confirmed after PO is received and invoice is paid in full. Please share this information with your Billing Contact person.

By checking the box, I acknowledge that I meet the pre-requisite skills: 1) have experience implementing PBIS for at least 1+ years, 2) I have knowledge and background in behavior interventions, 3) I have training and coaching skills/disposition, 4) I will participate in all scheduled days of training, complete all pre-reading, and complete all course activities by the end of the course in order to use licensed curriculum and receive a certificate for professional development CEU's.

By checking the box, I acknowledge that before beginning this course, my supervisor and I will sign a Participant Agreement (license agreement) and I will use the KOI Education licensed training materials and curriculum solely for my School or District’s internal operational purposes.

By checking the box, I acknowledge that PBIS TLC graduates will be given exclusive license to use KOI PBIS Curriculum, presentation slides, and training materials. KOI PBIS Manuals (digital or physical) will need to be purchased for each person attending my training. Books are available at https://www.koi-education.com/books from Amazon and AppleBooks.

By checking the box, I acknowledge that my seat is not confirmed until registration is paid in full. Cancelations must be received in writing at least 90 days prior to the course for a full refund, 60 days for a half refund, and 30 days for partial refund. A substitute may be assigned in my place but must register 30 days or more prior to the course. Email info@koi-education.com with substitute information and refund request.