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* 1. Your Name

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* 2. School Name

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* 3. Email

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* 4. Your Mobile (or Home) Phone

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* 5. School Phone

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* 6. Mailing Address (where any certificates or workshop materials may be sent)

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* 7. Subjects Taught (check all that apply)

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* 8. My school is

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* 9. Please list any food allergies or special dietary restrictions. (Type N/A if none.)

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