Teacher Workshop registration form

Contact Information

First Name Last Name
School Name School District
Street Address City
State/Providence Zip Code
Phone number e-mail address

Classroom Information

Grade/Grades you teach # of Students

                     

Location  DateTime     CPDUs   Cost
Oak Terrace School
240 Prairie Rd.
Highwood, IL 60040    
02/16/20054 PM to 6 PM2 CPDUsFree
Du Page PDC
E 15th Pl & S Grace St
Lombard, IL 60148		02/19/2005  10 AM to 4 PM5 CPDUs   Free
Shedd Aquarium Computer Lab             
1200 South Lake Shore Drive      
Chicago, IL 60605		02/26/2005 10 AM to 4 PM 5 CPDUs $40 *
Shedd Aquarium Computer Lab   
1200 South Lake Shore Drive                   
Chicago, IL 60605		03/12/200510 AM to 4 PM5 CPDUs$40 *

Please, choose the workshop you would like to attend

Additional Comments (If more than one teacher from your school will be participating in the workshop please add their names, e-mail addresses, and classroom information in the space below.)