Advancing Science

Spring 2010 Workshop Registration

March 8, 2010 at Gettysburg College

DO NOT SUBMIT VIA THE WEB!!!!

COMPLETE THE FORM, PRINT AND FAX IT TO 717-337-6157 UNTIL FURTHER NOTICE.

WE ARE EXPERIENCING TECHNICAL DIFFICULTIES

 

Before submitting this form, please note:

  1. Workshop space is limited to veterans of the Advancing Science program.
  2. This information is insecure, and could be intercepted in transit. If you have any concerns about sending this information over the Internet, contact Val (see bottom of page).
  3. Please complete all fields.
  4. To complete your registration, press the "Submit" button at the end of the form.
  5. Please do not use this method of registration if you do not have a valid e-mail address that you check regularly. We may respond with important information about your registration to the e-mail address you list on your form.

Thank you for your interest in the Advancing Science program.

Registration Must Be Received By: Friday, February 19, 2010

(Workshop space is limited; early registration is strongly encouraged.)

 

                           
TEACHER INFORMATION:  
Name
E-mail Address
Home Address
Home City
Home State Pennsylvania  Other
Home Zip Code
Home Phone
SCHOOL INFORMATION:  
School Name
School District
School Address
School City
School County
School State   Pennsylvania 
School Zip Code
School Phone
Grade(s) Taught
(Check all that apply)
K 5 9
1 6 10
2 7 11
3 8 12
4    
Subject(s) Taught 
(Check All That Apply)
Biology Earth Science 
Chemistry   Environmental Science
Physics Physical Science
Other  General Science
WORKSHOP INFORMATION:  

Scheduling Notes:

Track
Select
A

Elementary Science (Grades K-4)

B

Life Science/Biology (Grades 5-12)
C

Physical Science/Chemistry (Grades 5-12)
Comments/Questions For Advancing Science
PLEASE NOTE: Space is limited, so register early! If you do not receive confirmation of your registration within one week of the workshop, please call 717-337-6150. See other notes on the workshop information page. Thank you. 

Information will be sent to:
Valerie Stone
Gettysburg College
300 N. Washington St.
Advancing Science Box 392,
Gettysburg, PA 17325

Phone: 717-337-6166
FAX: 717-337-6157
e-mail: advancingscience@gettysburg.edu

 

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