Center for Supportive Schools (CSS) Teen PEP Day of Learning and Information Session

Tuesday, December 8, 2015; 8:30 am-1:00pm

*Registration will begin at 8:30 a.m.; continental breakfast and lunch will be provided at no cost*

The McKimmon Conference and Training Center
North Carolina State University
1101 Gorman Street
Raleigh, NC 27606
(919)515-2277

**If more than one individual from your school/organization will be attending, please complete a separate online form for each individual.**

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* 1. Name:

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* 2. Title/Position:

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* 3. School/Organization:

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* 4. Street Address:

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* 5. Email Address:

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* 6. Phone Number: (Please provide the best number to use to contact you should there be last minute inclement weather updates.)

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* 7. The best way to contact me is:

Phone Number

Email Address

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* 8. Check One:

I plan to attend the event for the full day.

I plan to attend the information session (10:45 a.m. - 12:45 p.m.) only.

Thank you for registering for the Teen PEP Day of Learning and Information Session to learn more about Teen PEP in North Carolina. A confirmation with directions will be emailed to you prior to the event.

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* 1. Name:

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* 2. Title/Position:

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* 3. School/Organization:

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* 4. Street Address:

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* 5. Email Address:

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* 6. Phone Number: (Please provide the best number to use to contact you should there be last minute inclement weather updates.)

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* 7. The best way to contact me is:

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* 8. Check One:

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* 9. If you have any problems with this registration form, please call Maiya Preston at (301)455-4607 or email at mpreston@supportiveschools.org.