* 1. What is your first name?

* 2. What is your last name?

* 3. What is your work email address?

* 4. What is your personal email address?

5. What is your title?

6. What is the name of your school district?

7. What grade levels do you work with?

* 8. I am interested in earning a Continuing Education Credit for attending this workshop. I understand that if I want to earn a CEU, I need to bring a check for $20 to process the CEU.

9. I understand that by registering for this event, GLSEN is budgeting for me as a participant; therefore, I am committed to attending on Saturday, October 26th. I understand this workshop is FREE, because of the generous donations of these two organizations. They are ordering food and drink according to the number of participants, so I will attend the workshop and register at 8:00 in the morning at Trinity Cathedral.

* 10. I understand this email serves as my confirmation for attending the workshop. I realize I will not receive a confirmation email. Completing this on-line registration is my confirmation.

T