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ACT Workshop Registration

To sign up to attend our ACT Workshop on Saturday, September 27, 2008 at 9:30 AM, please fill out the form before and select Submit. The workshop is located in the Science Hall, Room 72, on the ESU campus. Check in begins at 9:15 AM, and the workshop will conclude by 11:30 AM. The cost is $10, which can be paid at registration that day. Complimentary lunch and football tickets are included for interested students.

First Name:

 *

Initial:

Last Name:

 *

Street Address:

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City:

 *

State / Province:

*
US residents: Please use the two-character abbreviation (e.g. CA) for the name of your state.

Zip Code:

 *

Country:

 *

Home Phone:

*

Cell Phone (if available):

High school currently attending:

 *

High School graduation year:

 *

Year of GED Completion

Major:

 *

Please Mark if you are an Education Major: Yes No
Are you planning to stay for lunch? Yes No

Are accommodations needed for the workshop?

 

Last Updated August 20, 2008