Roseau and Round Table Workshop Form
I am applying for the MAGE Roseau and Round Table Workshop that will take place in Roseau , Mn on August 14-16, 2008 . Check in will be at Roseau High School from 12:30 - 1:00 p.m. on the 14th.
NAME:
HOME MAILING ADDRESS (Street/City/State/Zip):
HOME/CELL PHONE NUMBER (include Area Code):
SUMMER EMAIL ADDRESS (primary contact will be via e-mail):
SCHOOL/OGRANIZATION NAME:
PRESENT POSITION (Title/Grades/Subjects):
SCHOOL DISTRICT NAME AND NUMBER:
Are you willing to share a room with one other workshop participant? [ ] Yes [ ] No
Note: If you would like your own room the approximate cost per night would be $70.00/ night plus tax
Is this the first MAGE workshop you have attended? [ ] Yes [ ] No
I would be willing to facilitate a Round Table Discussion for Elementary/Middle School teachers while the High School round Table is being held? [ ] yes [ ] No
I will be attending:
[ ] The High School Round Table meeting only on Thursday from 1 – 4 p.m. ONLY
[ ] I will be attending the entire workshop
- If you do not have a passport you may not be able to attend the parts of the workshop that will take us into Canada . You may still attend the other parts of the workshop.
Are there any dietary restrictions that we need to be aware of?
Email to Sharon at: sharonmn@aol.com by July 18th, 2008
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