Marketplace for Kids
Region 2 Minot Registration - Part 1
Region 2 Minot Marketplace for Kids Education Day - Tuesday, April 13, 2010
Minot State University, Minot, ND
PART 1: CLASS/GROUP REGISTRATION FORM

(Please complete all information!)


Do not use the back button on your browser! Doing so could cause your registration to be lost!
* Denotes a required field!
Name of Regional Education Association:*
Name of School/Organization:*
Grade:*
Complete Mailing Address of School/Organization:*
(your Education Day Materials will be mailed to this address)
City/State/Zip Code:*
Title:*
(Miss, Mrs., Ms., Mr.)
Classroom Teacher/Advisor:* More than one teacher registering?
If more than one teacher is registering, please list:
Teacher Telephone (Daytime):*
Teacher Telephone (Evening):*
Teacher Email Address:*
Name of Person Completing Form:* Relationship to Classroom (i.e., parent, student teacher, etc.)*
Person to Call to Verify Information on Registration Forms:*
Telephone Number and Best Time to Call:*
PLEASE ANSWER THE FOLLOWING QUESTIONS:
Total Number of Registrants:*
Do you have any special needs/ADA requirements?
Total Number of Students:*
If yes, please explain:
Number of Students Exhibiting a Project:*
Number of Chaperones:*
Lunch: Students may bring a sack lunch. A beverage will be provided. A storage area will be available for sack lunches.
We will bring our own sack lunch(es).
Questions?
We want your registration to run smoothly, and we are here to help you! If you need assistance, or have any questions, please do not hesitate to contact Renee at 1-888-384-8410 or 701-663-0150 or email marketplace6@btinet.net.

Please click the "Next" button below to proceed to the next step.