Executive Development Program

2018 Executive Development Program Registration

Please complete all requested information.

Personal Information
First Name: *
Middle Name:
Last Name: *
Job Title: *
Organization: *
Street: *
City: *
State: *
Zip: *
Country:
Email: *
Phone: *
Fax:
Certification: CPRP APRP CTRS CPRE Other
PRB Subscriber: (check if yes)
If yes, enter your Subscriber name:

Note: Before submitting your payment for the 2018 EDP, contact Julie Knapp at julknapp@indiana.edu for the $30 off discount code.

Enrollment Information
Program: First Year Program Second Year Program *
Alumni Option
Special Accommodations: I require special accommodations or special menu. Please contact me.
Photo Policy:

IU EDP staff may take photos of IU EDP participants in class sessions and at special events . These photos may be used in future brochures, websites or other materials used to promote the IU Executive Development Program.

I understand and agree to this policy. *


Referral - Refer a park or recreation professional who you think would benefit from IU EDP
Name:
Agency:
City and State:
Email:
Phone:

* indicates required field

Payment directions will be provided after you click Submit