CONNECTICUT MUSIC EDUCATORS ASSOCIATION
About YouCMEA Member* First Last Membership Number*Email* Phone* School District InformationSchool District*Site of SessionDistrict Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Workshop InformationIndicate the preferred date for your workshop.Preferred Date of Workshop* Date Format: MM slash DD slash YYYY Preferred Time of Workshop* : HH MM AM PM Alternate Date of Workshop (if possible) Date Format: MM slash DD slash YYYY Alternate Time of Workshop : HH MM AM PM Session Topic Requested*Select oneAssessmentClassroom ManagementCulturally Responsive TeachingDeveloping Standards-Based CurriculumMusic Ensemble Recruiting and RetentionMusic and Literacy Connection- Inquiry and Language DevelopmentMusic and Special EducationNotational LiteracyStudent-Centered InstructionSupporting Diverse Learners Who will participate in this session?*All music teachers in my districtSome of the music teachers in my districtMultiple districts will participateAnticipated Attendance*Are you requesting consideration for a CMEA subsidy to offset the clinician's fee?*Subsidies may only be requested for Session Requests made prior to November 8.yesno Subsidy Request CMEA has a limited number of subsidies, in amounts up to $300 that are available to assist members in bringing an outreach program workshop to their district. Any subsidies awarded will not be paid to the district or to the applicant but will be applied by CMEA to the presenter's fee of $375. The school district is responsible for the remaining portion of the fee and must remit this payment to CMEA by check or school purchase order no later than two weeks prior to the workshop. CMEA will pay the presenter upon completion of the workshop. Choose One*We can have the workshop even if we are not granted a subsidy.We can only have the workshop if it is partially subsidized.The amount of subsidy I am requesting is:*Describe your need for financial assistance.*Describe in detail how this session would benefit your teachers, and/or why your district needs this session/topic.* AcknowledgementCheck off each box below signifying your understanding of and agreement to each statement* Select All My administration has approved making this request for a workshop session. If awarded a subsidy, the money will be applied by CMEA to the clinician's fee. It will not be mailed to you or your district. I understand that CMEA must receive my district's payment no later than two weeks prior to our workshop session or it will be cancelled.
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