Participant Registration Form s2

Participant Registration Form s2

<p>     Fees Registration</p><p>Native,Exotic, InvasiveOh My! WORKSHOP RainwaterHarvesting - WaterConservation and WaterQuality WORKSHOP ConservationEducation Featuring WET, WILD Learning & Tree WORKSHOP InnovativeDesignsPractices & Paving the Way to Sustainable Success Stories TOUR “ sessions Course OPTIONAL – Friday Short Pre-Service Teacher Registration(university students not teaching) RegularRegistration (postmarked after22,January 2013) Early RegistrationBird (postmarked on or before 22,January 2013) (choose Registration Options one) Email Address: (home,work):Preferred cell, Phone or City: Preferred Mailing or Address (home work): Name: First Please do not send cash. Credit cards are not accepted. are cards send Credit Pleasedocash. not Payment must accompany theregistration form. Feesbe will determined postmark by date. Allregistrations postmarked Full Includes:Symposium *Please provide *Please apersonalemail address if are you aformal educator schoolemailssystemtend— bounceto back. Please provide the Give AWhoop!” Whooping Crane WORKSHOP Send payment with completed form to: completedform payment with Send Makecheck payableto: order or money following information January by 22, 2013 be will considered Early as Birds. FEESDONOT INCLUDE LODGING. EnvironmentalEducation Association,conference activities, 3 meals.   </p><p> so that we may better 5652 5652 Highway 182, LA 70570 Opelousas, & Fisheries Wildlife Dept. of LA VeniseOrtego, Fisheries, Envir. RE: & Wildlife Dept. of LA Fund Ed. </p><p> serve your needs - See Course atdescriptions Subjectto availability Fullday sessions </p><p>GRADE LEVELS OF INTEREST: </p><p> Pre-School (below 1st)  Middle School (5th – 8th) Registration Early JanuaryBird Postmark 2013Deadline: 22, PARTICIPANT REGISTRATION FORM Environmental2013 Louisiana Education Symposium  College  Elementary (1st – 4th)  High 1 year membership to Louisiana th th School (9 – 12 ) www.wlf.la.gov/eec  Other: </p><p>State:</p><p>AFFILIATED </p><p>ORGANIZATION: </p><p>School Name: Last</p><p>University Zip:</p><p> Saturday   will attending I be thefollowing: Selection Meal meals    ______</p><p>Agency Symposium Symposium lunch on Saturday on Symposium breakfast EveningSocial on Friday I will joining you I be not for needs: have I special dietary Meat TotalAmount Enclosed Parish: Parish:</p><p>Other </p><p>Vegetarian below: top choices 3 Indicateyour $10.00 $25.00 $50.00 $35.00 Fax: </p><p>PleaWsee p rlovoidke f othrew foalrldow ing information so that we may better serve your needs - thatapply) (Check all to seeing you at GRADE LEVELS OF INTEREST: the Environmental st th th  Pre-School (below 1 )  Middle School (5 – 8 )  College R-______</p><p>Educatsiton th th th Included  ElemSeynmtapryo (s1iu –m 4!)  High School (9 – 12 )  Other: </p><p>AFFILIATED ORGANIZATION: School University Agency Other </p><p>We look forward to seeing you at the Environmental Education Symposium!</p>

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