COSEBOC - The Coalition of Schools Educating Boys of Color

COSEBOC Fourth Annual Gathering of Leaders
Registration and Logistics

Conference Regisration: Fill out this form below. The second page is the payment form. * = Required fields

Registration Information
* First Name:
* Last Name:
* Street Address:
* City, State, Zip
Phone:
Cell:
* E-mail:
School/Organization Information
* School/Organization:
* Your Title:
Street Address:
City, State, Zip
Phone:
Website:
Tell us a bit about your work and its relationship to the education of boys or young men of color.
Areas of Interest
Please give us an idea of what you are hoping to gain from the Gathering as well as any areas of particular interest	Assessment Curriculum and Instruction Parent/Family/Community Partnership School Counseling and Guidance School Environment and Climate School Leadership School Orgnization Other - Please specify
Miscellaneous Information
Howard University School of Education will be hosting breakfast and lunch for the conference. Please indicate any special dietary needs (such as allergies) you may have. We will also be touring and using other facilities at Howard. Please indicate if you have any physical restriction that would require transportation to the other halls.

Have you attended any of COSEBOC’s previous gatherings?	Yes No
If yes to above, which gatherings?	Boston Atlanta New Orleans
Additional Comments? Please share any questions or comments you may have about the upcoming Gathering
* Payment Method:	Online payment through PayPal Mail by check or Purchase Order

Hotel Reservation
Click here to reserve your hotel registration
Westin Hotel in Center City
1400 M Street NW
Washington, D.C., 20005

Registration Information