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? | |
| * Do you have internet access from a: | Lab? | Class? |
| Principal's Name: | ||
| * Name of School: | ||
| * School Address: | ||
| * City: | * State: | * Zip: |
| * School Phone: | * Fax: | |
| Basic Training & Workshop Aug. 2-6 | Research Workshop Only Aug. 5-6 | |
| ~ $20/day registration: | $100 | $40 |
|---|---|---|
| * 50% deposit required by 7/26/99 | - $50 | - $20 |
| Total due at registration: | $ | $ |
In order to contact you at home, if needed, please complete the following
information:
| Home Address: | ||
| City: | State: | Zip: |
| Home phone: | ||
Ms. Cyndy Henzel 4920 S. Browning Ln. Tucson, AZ 85746 (520) 883-1560, FAX: 883-4191 Email: chenzel@gci-net.com