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* First name: |
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| * Last name: |
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| * ABE or EL/Civics Program: |
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| * Position/role: |
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* Street address: |
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| * City: |
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| * State: |
*Zip: |
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* E-mail address: |
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* Phone number with area code: |
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* Days you will attend: |
Tues. June 2 Wed. June 3
Please note that this is a 2-day event; registrations for one day will only be accepted if space permits and after 2-day registrations are processed. Please note that the cost will remain the same. |
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Event cost: |
$25 (includes meals, snacks and materials) |
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Payment: |
Please make PO's/checks payable to Hamline University.
* Purchase order or check: #
(if number is not yet known, put "pending") |
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* Check one: Check is being mailed
PO is being faxed |
| Send payment to: |
ATLAS - Center for SLTL
Hamline University
1536 Hewitt Ave., MS-A1790
Saint Paul, MN 55104
FAX: 651-523-3083 |
| Special needs: |
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REGISTRATIONS MUST BE RECEIVED NO LATER THAN TUE. MAY 26
NOTE: When you hit "Submit," a registration confirmation screen will pop up; this will be the only confirmation you receive. If this confirmation screen does not appear, please contact the ATLAS office (651-523-2503) to ensure that your registration goes through. Thank you!
Please print this page for your records before submitting. |
