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Outreach Programs > Professional Development > Workshops > Registration

Hill-Funded Online Course

Registration

Salutation:


Full Name:


Home Phone:

Home Address:

Home City:

Home State:

Home Zip:

Home e-mail:


School District:

Current School:

School Address:

School City:


School State:


School Zip:


School Phone:

School Fax:

School E-mail:

Current Teaching Assignment (Please check all that apply):

Regular Classroom Grade Level: Content Area:
Resource Inclusion Grade Level:
Administrative Elementary Middle Secondary
Other:

Educational Background: (Please check all that apply):

Undergraduate Graduate Experience working with LD/ADHD students

Would you like a vegetarian meal?:

Yes  


I would like to register for the following Hill funded online course:

Payment Type:

Note: Please allow one week for processing. You will be contacted with a login and password.

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