Celebrate Calm: Calm Schools
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1. Back - to - School with Kirk Martin and Celebrate Calm

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10 Ways to Guarantee Your Child’s Success

Saturday, October 2, 2010
10:00 AM - Noon and 1:00 - 4:00 PM
Luther Jackson Middle School - Auditorium
3020 Gallows Rd
Falls Church, VA 22042

1. Contact Information

Contact Information Name:
Email Address:
Phone Number:

2. Please indicate which workshops you will attend.

Please indicate which workshops you will attend. I will attend both workshops

Back-to-School - Calm School from 10 - Noon

Survive the Education Earthquake from 1 - 4 PM

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3. Total number of participants
attending this workshop in your group.

	Select the number attending in your group.
Total number in group	Total number of participants attending this workshop in your group. Total number in group Select the number attending in your group.

4. How did you hear about this workshop?

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PRC web site	*How did you hear about this workshop? PRC web site Please Check answer
Celebrate Calm web site	Celebrate Calm web site Please Check answer
Keep In Touch Email	Keep In Touch Email Please Check answer
Flyer sent home	Flyer sent home Please Check answer
Parent group	Parent group Please Check answer
Listserv	Listserv Please Check answer

Other (please specify)