Your Information

Registration Options

Workshop Registration Fee ($100.00)
Includes meals, sleeping accommodations & field trip transportation. In addition you will receive professional development hours (if not seeking ISU grad credit).
Registration Fee ($100) + ISU Grad Credit ($250) ($350.00)
GEO 493.07 - Geology of Illinois: Teaching Rocks, Minerals & Mining in the Classroom (2 credit hours)
Registration Fee ($100) + ISU Grad Credit (PAY LATER) ($100.00)
You will be invoiced for the $250 course fee in July. Payment must be received on or before the first day of the workshop on July 22nd.

Name

Address

You may share my email address with other participants.

Primary Phone Number

T-Shirt Size

Name of School

City or town where school is located

Grade / Subject

Your Illinois Educator Identification Number (enter N/A if you do not want credit)

In Case of Emergency Call

Emergency Phone Number

Name of teacher you would like to share a room with

Check here if you live nearby and wish to go home each night.

Any special dietary needs?

How did you hear about the workshop?

Billing Information

Name

I am representing an organization

Credit Card

Address

Phone Number