First Name: Last Name:

Home Address:

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City: State: Zip:

Home Telephone: Email Address:(Example: yourname@yourdomain.org. If your email address is incorrect, you will NOT receive notification that you are registered for the class.)

Grade Level/Teaching Assignment: Choose a grade level K 1 2 3 4 5 6 7 8 9 10 11 12 Other (This is so that the instructor can better understand his/her audience)

Choose Your School: York High School York Middle School Coastal Ridge Elem. School Village Elem. School Other Choose a School If "Other", please indicate what district/school here:

Please choose the breakout session you would like to attend: First Choice Skillful Teacher Differentiation Connected Math II Everyday Math Mentoring for Novice Teachers Service Learning Making Connections: Language, Story and Reading Building Comprehension and Vocabulary Tools for Professional Learning Communities Technology Tools GIS Exceptionalities Natives of Maine Learning Locally, Applying Globally Six Traits Special Education Law Second Choice Skillful Teacher Differentiation Connected Math II Everyday Math Mentoring for Novice Teachers Service Learning Making Connections: Language, Story and Reading Building Comprehension and Vocabulary Tools for Professional Learning Communities Technology Tools GIS Exceptionalities Natives of Maine Learning Locally, Applying Globally Six Traits Special Education Law

Out-of-district fee

Payment: Please indicate method of payment -

Personal check Check Number

or

Purchase OrderP.O. Number

Send payment of $500.00 per person payable to "York School Department" to:

Registration Deadline is April 27, 2007. Space is limited. Some adjustment of the schedule may be necessary due to instructor needs or participant numbers.

Thank you. Please click the Submit button, only once, below. You may need to be patient if your Internet connection is slow. You will receive email notification that this request has been submitted. Any other paperwork required by your individual school district negotiated agreement should be submitted to the proper administration and/or relicensing board.