Summer 2025 Base Camp and Leadership Summit Seat Request Form

CONTACT INFORMATION

District Name*

Superintendent Name*

Superintendent Email*

Contact Name*

Contact Email*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

REQUESTED SEATS

Check-in: June 8, 2025 Cohort Dates: June 9-13, 2025 Location: Jekyll Island, Georgia

The estimated value of each seat is $4,200. GLISI awards a per-seat credit of $300, making the price of attendance $3,900 per participant.

# Seats *

Enter the number of cohort seats requested (minimum of 5) in # Seats.

Price: $3,900.00

HOTELS

GLISI has reserved blocks of rooms at four hotel properties: The Westin Jekyll Island, Home 2 Suites by Hilton, Courtyard Marriott, and Residence Inn by Marriott. Home 2 Suites by Hilton and The Westin Jekyll Island are within walking distance of the convention center. Hotel assignments are made on a first-come, first-serve basis, with consideration to room block availability and team size.

You will receive an invoice upon registration. Please provide contact information for invoicing in the spaces below.

INVOICING

Invoicing Contact Name*

First Last

Invoicing Contact Email*

Invoicing Contact Phone*

Preferred method of invoicing*

Invoice upon confirmation of registration
Invoice on January 1

Statement of Financial Hardship*

If the registration fee will prevent you from attending, please use this space to provide a brief narrative explaining your financial hardship. Additional scholarship assistance may be available. Priority for financial assistance will be given to registrations received by February 15, 2025.

STRATEGIC ALIGNMENT

Please provide a brief overview of how attending Base Camp and Leadership Summit aligns with your improvement plan.*

What outreach methods influenced your registration?*

Select all that apply:

Brochure or Postcard
Outreach from GLISI Staff
Facebook
Twitter
Website
Colleague Referral
Other

Please provide a brief explanation*

CANCELLATION POLICY

GLISI will confirm your reservation pending seat availability upon receipt of this form and will invoice upon confirmation unless other terms are agreed upon by you and by GLISI. All invoices are due within 30 days of invoice date. Registrations are only valid for the Summer 2025 cohort. Cancellations, reductions in team size, or requests to adjust invoice terms are not guaranteed and should be made in writing by March 14, 2025 with a request to Jennie Welch at [email protected].

SUPERINTENDENT AUTHORIZATION

Check the box below to verify that the Superintendent has reviewed and agreed.*

The Superintendent has read the cancellation policy above.

REGISTRATION

2025 Summer BCLS Seat Request Form

2025 Summer Base Camp and Leadership Summit: Seat Request Form