CSDE Request for District Contact Info for Processing Summer 2022 CT-SEDS Expert Training Stipends

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* 1. Contract Signatory Name (person authorized by BOE, or governing body of your organization)

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* 2. Contract Signatory Direct Email

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* 3. Contract Signatory Phone

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* 4. District/Organization Name

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* 5. Organization Street Address

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* 6. Organization Town/City

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* 7. Organization Zip Code

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* 8. Organization Business Manager Name

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* 9. District Business Manager Direct Email

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* 10. Organization Business Manager Phone