Directions: email or fax the following information to the address below ASAP.
Todays Date:
| * Teacher Name: | ||
| * Email: | School / Home? | |
| What grade level do you teach? | What subject? | |
| Principal Name: | ||
| *Name of School: | ||
| * School Address: | ||
| * City: | * State: | * Zip: |
| * Phone: | * Fax: | |
| * Meal ticket? | Yes / No | |
| * Circle any night you will need a room: | Nov. 7 | Nov. 14 |
| * Do you wish to share a room? | Yes / No | Smoking / Non? |
In order to contact you at home, if needed, please complete the following
information:
| Home phone: | ||
| Home Address: | ||
| City: | State: | Zip: |
Ms. Sallie Cochran Biosphere 2 Center P.O Box 689 Oracle, AZ 85623 (520) 896-6203, FAX: 896-6361 Email: educate@bio2.edu