RIROE Workshop Registration Online Form

Registration forms are due one week prior to the scheduled workshop. All fees must be mailed.

To register for a workshop, please complete this form and mail your check payable to:
Rock Island County Regional Office of Education
3430 Avenue of the Cities
Moline, IL 61265

Important: Cancellations must be sent 7 days prior to the workshop in order to receive a refund.

Explanation: Must have Social Security Number. It is needed for CPDU's transcripts.

Questions? Please call Julie Cox at 309-736-1111.

If you use this online form,

1. Enter only numbers and no dashes for the phone number entry.

2. REMEMBER to hit the submit button upon completion of form and if completed correctly a "Thank You" page will come up and Julie will email you confirmation.

3. If you do not receive a email confirmation, please call Julie at 736-1111.

1. Email Address *
2. Your Full Name *
3. Your Title
4. Workshop ID (in Regional Reporter) *
5. Title of Workshop
6. Social Security Number (no dashes) *
7. County
8. School District Name and Number
9. School Name
10. Home Phone Number (no dashes)
11. Home Address
12. City and State
13. Zip Code
* required