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Workshop form

Employee Information  
Name
Name
Phone Number
Cell Phone
Fax
 
Reason for Attending Workshop (check all that apply)
  General interest in providing science outreach
  Want to assist specific student
  Want to assist specific teacher
  Want to assist specific school
  Recreational event i.e., birthday party
  Opportunity for professional development
  Other, Please explain
 
   
   
 
   

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Supported by a generous gift from the S.D. Bechtel, Jr. Foundation