Registration Page

Teaching With Primary Resources Registration
All fields are required

First Name:

Last Name:

Home Phone:

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Home Address:

Home City:

Home State:

Home Zip:

Preferred Email:

School Email:

Select your School District:

School Name:

School Address:

School City:

School State:

School Zip:

School County:

School Phone:

- -

Extension:

School fax:

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What grades do you teach?

Pre-K	Kindergarten	1st	2nd
3rd	4th	5th	6th
7th	8th	9th	10th
11th	12th	College/University

What subjects do you teach?

All (self-contained)	Art	Business
Computers/Technology	Foreign Language	Global Issues /Current Events
Health	History	Language Arts/English
Library/Information Literacy	Mathematics	Music
Other	P.E.	Science
Social Studies	Special Education	Speech
Title I

Are you a librarian?

Yes No

Are you a media specialist?

Yes No

Select a Registration Option Below:

Select

Registration Fee

Graduate Credit Fee

Level

Online

Date

Time

Day

Year: 2010 Semester: Fall

$60

$40

Online

Sept 16	4:30-7:30 pm	Thursday
Dec 2	4:30-7:30 pm	Thursday

Location: Milner Library, 201 N. School St., Normal, IL
Prerequisite: Completion of Level 1

$60

$40

Online

Sept 14	4:30-7:30 pm	Tuesday
Nov 30	4:30-7:30 pm	Tuesday

Location: Milner Library, 201 N. School St., Normal, IL

Would you like Graduate Credit for this workshop?
Participants will receive 2 credits.

Yes No

Would you like CPDU credits for this workshop?
Participants will receive 25 cpdus.

Yes No

If you have comments, questions, or special needs please leave it here: