Fill out the following form to register for a workshop. All submissions are time stamped and workshops are filled in the order received. Don't forget to mark the dates for the workshop you choose on your calendar! We look forward to seeing you! Please remember our workshops are for North Carolina high school teachers only.

First Name:           Last Name:

Home Information:

Mailing Address:

City:

State: Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Other / Not in the US         Zip:

Home Phone:       Home E-mail:  

Check here if you prefer for us to contact you using your HOME e-mail:

School Information:

School Name:

Mailing Address:

City:

State: Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Other / Not in the US         Zip:

School Phone:       School E-mail:  

Check here if you prefer for us to contact you using your SCHOOL e-mail:

Grades Taught:         Subjects Taught:

Please select the workshop you would like to attend:

Select Workshop Raleigh, NC: June 17-19, 2008 Greensboro, NC: July 22-24, 2008 Elizabeth City, NC: August 5-7, 2008