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December 7 Seminar Registration
Last Name:
First Name:
Email:
Position (i.e. Classroom Teacher, Staff Development Specialist, etc.):
Grade Level(s):
Subject(s) Taught:
Approximate Number of Students Taught:
School Name:
School Address:
Address to Mail Stipend:
City:
State:
Zip Code:
The platform of your computer (Mac/PC):
Type of Internet connection (i.e. cable, DSL, dial-up):
How did you hear about this opportunity?
Indicate if you would like to be notified of other EET opportunities such as future online seminars?
Yes. Please keep me informed of other EET opportunities.
No thank you. Please do not inform me of other EET opportunities.
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