Island Energy Inquiry Workshop Maui Nui 2010
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1. Introduction

 
This is the online registration form for the Island Energy Inquiry Workshop hosted by the MEDB Women in Technology Project. The workshop is 9:00 - 4:00 October 7th & 8th, with January 15th (Sat.) field trip and a final evening event 5:00 - 8:00pm February 15th.
Priority will be given to DOE teachers of grades 5-8.

*All teachers need to complete this registration form. Teachers that are choosing the PD credit rather than stipend will ALSO need to fill out the registration on the PDE3 website.

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1. Full Name

2. My school is on:

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3. School

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4. Please check your grade level(s):

5. What subject area(s)do you teach?

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6. Email

7. Alternate email address, if different from above.

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8. School phone + Extension

9. Alternate phone number (home and/or cell)

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10. Please describe at least one thing you hope to learn in this workshop.

11. Do you plan to seek the Professional Development (PD) Credits for this course OR the $150 stipend? (Participants must decide at time of registration. Mahalo.)