WELS Education Conference 1Personal2Service/Membership3Sectionals4Billing HiddenToday's date MM slash DD slash YYYY Personal InformationFull name(Required) Select one . . .Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Suffix First name as it will appear on conference badge(Required) I am presenting a sectional or pre-conference session(Required) Yes No Home address(Required) Address line 1 Address line 2 City State/Province/Region Zip/Postal code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone 1(Required)Phone type 1(Required)Select one . . .CellHomeOfficeOtherPhone 2Phone type 2Select one . . .CellHomeOfficeOtherE-mail(Required) Enter e-mail Confirm e-mail Dietary restrictions and/or special needsEmergency ContactContact name(Required) Relationship to attendee(Required) Day phone(Required)Evening phone(Required) Current Service or MembershipChurch/School(Required) City(Required) State/Province(Required)Select one . . .AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonSchool role(Required)Select all that apply. School Leader - Early Childhood Ministry Teacher - Child Care School Leader - Elementary School Teacher - 3K/4K School Leader - High School Teacher - 5K Pastor Teacher - Elementary Staff Minister Teacher - Middle Other Teacher - High School Other school role(Required) Conference SelectionsReference the website for sectional descriptions. Select a registration option(Required) Pre-Conference Day Full Conference Full Conference + Pre-Conference Day Monday One-Day Pass Monday One-Day Pass + Pre-Conference Day Tuesday One-Day Pass Tuesday One-Day Pass + Pre-Conference Day Pre-Conference Day 1 to 5 p.m.(Required)Select one . . .The Hierarchy of School Growth Needs (Dana Kirchoff)Creating Successful Teacher Feedback Systems (Meredith Pucci)Supervision of Instruction: Done "With" Teachers, Not "To" Them (Dr. Jeff Wiechmann)Moving the MDP from the Graveyard of Good Intentions to a Classroom Reality (Alan Bitter & Dr. Jon Schaefer)Partnering with Parents in Early Childhood Programs: A Comprehensive Approach (Shawna Mehlberg)Current Events in SPED Impacting WELS Schools (Dr. Mark Murphy and Kelli Green)New Paradigms for the LES/Church Musician (Rev. Bryan Gerlach, Rev. Michael Schultz, Jeremy Bakken)NoneSectional 1(Required)Select one . . .Essential Steps for Providing Successful Learning Environments (Ashley Schoof)America's Founding and Why It Is Relevant to Young Christians (Tony Perry)Rethinking Leadership - What's missing and how does it impact our Leadership and our Students (Donald Kudek)Personal Passion Projects in Technology (Colin Paustian)Building a Culture of Data Use in Your Schools (Jessica Knierim)Building a School Website for Outreach (Dana Kirchoff)All are precious in His sight! (Erin Dooley)Tools for Engagement (Dr. Eric Jensen)NoneSectional 2(Required)Select one . . .Working with Parents of Students with Special Challenges (Paul and Jane Mose)"Why did I get that grade?" - Teaching Metacognitive Writing through Writing Revision and Rubric Reflection (Kyle Fax)Rethinking Leadership - What's missing and how does it impact our Leadership and our Students (Dr. Donald Kudek)Feedback: The Key Element of Educational Ministry (Dr. Ryan Rathje)Building a Culture of Data Use in Your Schools (Jessica Knierim)Impacting New Teacher Growth with Instructional Coaching (Meredith Pucci)Early Childhood Observation and Assessment: Communicating Children's Learning and Development with Parents (Shawna Mehlberg)Tools for Engagement (Dr. Eric Jensen)NoneSectional 3(Required)Select one . . .Encouraging Spiritual Growth in the Home (Rev. Phil Huebner)Voice, Choice, Pace, and Place - Tools to Support Blended Learning (Jason Schmidt)High Expectations Teaching in Diverse Classrooms (Dr. Ben Clemons)Connecting ECE Families to Jesus and the Congregation (Maria Gines and Rev. Caleb Free)Reach New Families with a Sustainable School (Dr. Jeff Lemke)Bridging the Opportunity Gap: Special Education in WELS Schools (Dr. Mark Murphy and Kelli Green)Building a Foundation for Leadership—Spiritual, Emotional, and Physical Health and Resiliency (Greg Schmill)NoneSectional 4(Required)Select one . . .Summative Assessment of In-Service Teachers (Dr. Jeff Weichmann)Practice What you Preach: MDP in Action (Alan Bitter)Social and Emotional Learning in Our Classrooms (Kayte Gut)Using Universal Design for Learning (UDL) to Improve Student Achievement (Kari Muente)What is your School's HQ? (Shawn Herkstroeter)Shepherding Shepherds for Educational Outreach (Rev. Paul Steinberg)Multi-age Teaching and Learning: What it is, how it is different, and why it matters! (Dr. Cindy Whaley)NoneSectional 5(Required)Select one . . .Summative Assessment of In-Service Teachers (Dr. Jeff Weichmann)Practice What you Preach: MDP in Action (Alan Bitter)Early Childhood Ministry and Board Collaboration (Rachel Burgess)Using Universal Design for Learning (UDL) to Improve Student Achievement (Kari Muente)What is your School's HQ? (Shawn Herkstroeter)Benefits of Developing a Positive Relationship with your Local Public School District (Dr. Lowell Holz)Multi-age Teaching and Learning: What it is, how it is different, and why it matters! (Dr. Cindy Whaley)NoneSectional 6(Required)Select one . . .Screens: Success or Sabotage for Schools? A Discussion of Children, Screens, and Learning (Dr. Navsaria)Cultivating Compassion (Jeremy Bakken and Rev. Ray Schumacher)Fostering a Formative School Culture (Dr. John Meyer)School-Based Counseling: Leveraging All Available Resources to Meet Students’ Needs (Laura Reinke)Creating Unforgettable Lessons in Your Classroom (Andy Van Weele)Supporting Social and Emotional needs of Children with Autism Spectrum Disorder (Dr. Rachel Youngblom)NoneSectional 7(Required)Select one . . .Cultivating Compassion (Jeremy Bakken and Rev. Ray Schumacher)Building on the Solid Foundation (Rev. Kyle Bitter)Early Learning Standards and Learn by Play (Becky Lindenberg/Janine Thies)Using Technology to Spark Creativity and Higher Order Thinking Skills (Rachel Feld)Supporting Social and Emotional needs of Children with Autism Spectrum Disorder (Dr. Rachel Youngblom)Effective Strategies when using MAP Data (Michael Koestler)NoneSectional 8(Required)Select one . . .Books Build Better Brains: How Promoting Literacy is Key to Early Brain and Child Development (Dr. Navsaria)Supporting the Emotional Health of Teachers: Resources for Care from Christian Family Solutions (Dan Nommensen)Called to be a Witness (Rev. Earle Treptow)The “Who Am I?” Crisis Among Teens Today (Rev. Phil Huebner)NoneSelect free Pre-Conference Evening option(s)(Required) Evening session 6 to 7 p.m. Evening session 7:15 to 8:15 p.m. None Evening 6 to 7 p.m.(Required)Select one . . .Organ Reading SessionPiano Reading SessionChoral Reading SessionRound Table: The Director of Parish Music PositionNoneEvening 7:15 to 8:15 p.m.(Required)Select one . . .Organ Reading SessionPiano Reading SessionChoral Reading SessionRound Table: The Director of Parish Music PositionNoneSelect a swag itemReview details and sizing at welsedtechlead.com/swag. Drink Tumbler WELS Polo Shirt Adult polo shirt size(Required) Men's Small Men's Medium Men's Large Men's 1X Large Men's 2X Large Men's 4X Large Men's 5X Large Women's X-Small Women's Small Women's Medium Women's Large Women's 1X Large Women's 2X Large Conference fee Price: Discount code Total $0.00 Verify total(Required) Total fee is correct. Proceed to Billing section My total is $0 If your total is zero after entering a discount code, please proceed to the privacy policy and then press the Submit button to finish your registration process. Refund policy: Refunds that are requested in writing before May 31 are subject to a $50 non-refundable charge. No refunds can be made after May 31.Billing InformationCredit or Debit card information(Required) DiscoverMasterCardVisaSupported Credit Cards: Discover, MasterCard, Visa Card number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration date Security code Name on card Billing address(Required)The address you enter must match the address on file with your bank/credit card company. If the address is not correct or if required fields are left blank, an error message will display. Same as home address (MUST MATCH WITH BILLING STATEMENT) Address line 1 Address line 2 City State/Province/Region Zip/Postal code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Data Privacy & Permission(Required) I AGREE with the terms of the WELS Privacy Policy.NOTE TO EU RESIDENTS: By submitting this form you consent to any and all information you provide and submit via the site being sent to the United States of America. The United States has not sought nor received a finding of “adequacy” from the European Union under Article 45 of the GDPR. WELS relies on derogations for specific situations as set forth in Article 49 of the GDPR. You are also informed that the United States presently does not have an adequate level of personal data protection as determined by the European Commission’s adequacy decision on October 6, 2015 (case c-362/14) and articulated in the European Union’s General Data Protection Regulation and has not received a similar designation of adequacy by any other foreign data protection authority. You agree to the transfer of your data and personal data to the United States, however, to be used in accordance with WELS Privacy Policy. Δ WELS Education Committee: welsedconference@wels.net Ref: WELS Education Conference