* 1. Your Name

* 2. School Name

* 3. Email

* 4. Your Mobile (or Home) Phone

* 5. School Phone

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

* 7. Subjects Taught (check all that apply)

* 8. My school is

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

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