I intend to enroll my school in the Arts Impact Summer Institute and School Year Mentorships. Minimum of 3 teachers per school. School Name(required) Contact Name(required) Contact Phone Number Contact Email Address(required) Number of Teachers(required) Teacher Names (separated by commas - include email address) Phone Number Select Institute Dates Tacoma; July 31 - August 4 2017; Broadway Center for the Performing Arts Seattle; August 7 - 11 2017; Seattle Art Museum SAIL; August 14 - 18 2017 Wait List Completing this form will place teachers listed on an official wait list. Notification of final enrollment will be made on or before June 1, 2017. Payment (costs are per year): Summer Institute: $850 per teacher (based on total enrollment of 25 or more teachers from all schools) Mentorships: $1,275 per teacher Payment arrangements are flexible. Teacher Substitution Clause If after turning in a registration form a teacher drops from the program, he/she can be replaced by another teacher from the same school up until the first day of the Summer Institute. However, if a replacement for the teacher who dropped is not found, a refund will not be issued for that teacher after July 1. At least three teachers from a school must be enrolled at the time of the Summer Institute to be admitted into the program. No refunds for teachers will be issued after July 1, 2017.