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Powerful Learning Network Registration Form
Powerful Learning Network Registration Form
Powerful Learning Network Registration Form
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2026-09-01T00:17:02-05:00
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Name
This field is for validation purposes and should be left unchanged.
Your Information
Name
(Required)
First
Last
District
(Required)
Position (e.g. Principal, Director, etc)
(Required)
Financial Information
Financial contact name
(Required)
First
Last
Financial contact email
(Required)
How many members are registering?
(Required)
When would you like to be billed?
(Required)
Now
After October 1st
Half and Half
Other
How would you like to pay?
(Required)
P.O.
Credit Card (Subject to a 3% Convenience Fee)
Other
Which PLN cohort are you registering for?*
(Required)
Alabaster
Auburn
Gardendale
Middle Grades (meets in Alabaster)
Montgomery
North (meets in Athens)
Oxford
West (meets in Tuscaloosa)
Large Group Information
Are you registering more than 8 attendees for PLN?*
(Required)
If you are registering more than 8 people, a member of our team will email you a Google Sheet that will be easier to fill out for a large group.
Yes
No
Team Information
Are you ready to provide the names and contact info for your team members?
(Required)
If you already have your team roster, we can collect that now. If not, we can set up a time to get that information closer to our PLN launch date. We will need your team roster completed by September 19th, 2025.
Yes
No
Team Lead
We have found that our most successful PLN teams always have one thing in common: a central point of contact that leads the team and provides cohesiveness to the learning. This may be you or another team member, and they will help with communication and accountability throughout the year.
Team Lead Name
(Required)
First
Last
Team Lead Email
(Required)
Team Lead Phone Number (if preferred)
Team Lead Position (e.g. Principal, Instructional Coach, Lead Teacher, etc)
(Required)
Team Member Information
Please list your team members below.
Please include the Team Leader here as well. Thank you!
Team Member 1
Team Member 1 Name
First
Last
Team Member 1 Email
Team Member 1 School (if applicable)
Team Member 1 Position (e.g. 3rd grade ELA, 9th grade social studies, Instructional Coach, Media Specialist)
Team Member 2
Team Member 2 Name
First
Last
Team Member 2 Email
Team Member 2 School (if applicable)
Team Member 2 Position (e.g. 3rd grade ELA, 9th grade social studies, Instructional Coach, Media Specialist)
Team Member 3
Team Member 3 Name
First
Last
Team Member 3 Email
Team Member 3 School (if applicable)
Team Member 3 Position (e.g. 3rd grade ELA, 9th grade social studies, Instructional Coach, Media Specialist)
Team Member 4
Team Member 4 Name
First
Last
Team Member 4 Email
Team Member 4 School (if applicable)
Team Member 4 Position (e.g. 3rd grade ELA, 9th grade social studies, Instructional Coach, Media Specialist)
Team Member 5
Team Member 5 Name
First
Last
Team Member 5 Email
Team Member 5 School (if applicable)
Team Member 5 Position (e.g. 3rd grade ELA, 9th grade social studies, Instructional Coach, Media Specialist)
Team Member 6
Team Member 6 Name
First
Last
Team Member 6 Email
Team Member 6 School (if applicable)
Team Member 6 Position (e.g. 3rd grade ELA, 9th grade social studies, Instructional Coach, Media Specialist)
Team Member 7
Team Member 7 Name
First
Last
Team Member 7 Email
Team Member 7 School (if applicable)
Team Member 7 Position (e.g. 3rd grade ELA, 9th grade social studies, Instructional Coach, Media Specialist)
Team Member 8
Team Member 8 Name
First
Last
Team Member 8 Email
Team Member 8 School (if applicable)
Team Member 8 Position (e.g. 3rd grade ELA, 9th grade social studies, Instructional Coach, Media Specialist)
Additional Information
Please provide any additional information or special requests here.
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