LBJ School - Governor's Center for Management Development

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GCMD Registration

Program Title: Teambuilding

Date(s): January 13 - 14, 2010

Location: The Commons, Room 1.130, J.J. Pickle Research Center, 10100 Burnet Road, Austin, Texas (Map and Parking Info.)

Registration Fee: $525

One registrant per form, please. This form can either be filled out online and submitted electronically or printed and submitted by mail or fax. If you are required to obtain supervisory approval, please obtain approval before submitting this form. Please refer to the cancellation policy below.

Printed applications can be faxed to 512-475-8111 or mailed to:

Governor's Center for Management Development
Lyndon B. Johnson School of Public Affairs
The University of Texas at Austin
3001 Lake Austin Blvd. Rm. 3.306
Austin, TX 78703-4204

Please call 512-475-8100 with any questions.

Please enter your registration information below:

(* indicates a required field)

First Name*
Last Name*
Nametag (Preferred first name)*
Title*
Gov. Agency*
Department Name*
Address*
Mail Code
City*	State* ZIP Code*
Phone*	Fax
Email Address*
Manager's Name*
Manager's Title*
Manager's Email Address
Emergency Contact
Emergency Contact Phone
Voucher/P.O. #

If you have special accommodation needs due to a disability please contact us at 512-475-8100.

Cancellation Policy
Cancellations may be made by phone but must be followed up in writing. Participants must notify their agency liaison and the Governor's Center for Management Development if they must cancel. Cancellations received eight (8) or more days before the class date will not be billed. After that, cancellations or rescheduling are subject to the entire class tuition. Substitutions for registered participants will be accepted up to the start date for each class. Please note that if you don't cancel and don't attend, you will be billed for the full tuition.

Notice Concerning Your Information
The Texas Public Information Act, with a few exceptions, gives you the right to be informed about the information that The University of Texas at Austin collects about you. It also gives you the right to request a copy of that information; and to have The University correct any of that information that is wrong. You may request to receive and review any of that information, or request corrections to it, by contacting the University's Public Information Officer, Office of Financial Affairs, PO Box 8179, Austin, Texas 78713 (email:cfo@www.utexas.edu).

I have read, understand, and will comply with the above cancellation policy