PLT registration form 1. PLT Workshop Registration Question Title * 1. Contact Information (Required.) First Name: * Last Name: * Address: * City/Town: * Zip: * State: * -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming Phone Number 1: * Phone Number 2: Email Address: * Question Title * 2. School/Organization: (Required.) Question Title * 3. Date of the workshop for which you are registering: (Required.) Date Date Question Title * 4. Location of the workshop for which you are registering: (Required.) Question Title * 5. Amount of check being sent to Project Learning Tree, Colorado State Forest Service, 9769 W. 119th Dr. Broomfield, CO 80021**MAKE CHECK OUT TO CSFS, AND PUT WORKSHOP DATE & LOCATION AT THE BOTTOM OF THE CHECK** (Required.) Question Title * 6. I understand that the workshop may be cancelled by the instructor if a minimum number of participants have not registered by the deadline, usually one week before the workshop date, and that fees will be returned. (Required.) Yes No Question Title * 7. I understand that this workshop fee is not refundable if I cancel my registration after the deadline, but that it may be applied towards a future Project Learning Tree workshop. (Required.) Yes No Question Title * 8. I understand that fees for university tuition are additional and optional and are to be paid at the workshop if desired. (Required.) Yes No Question Title * 9. I learned about this workshop from (Required.) Question Title * 10. With what age/grade level will you be sharing PLT Activities? (Required.) Question Title * 11. I have previously attended a PLT workshop. Yes No Date? Done