NOYCE Workshop Registration

STEM Teacher Workshop Registration: Active Learning and Data-Driven Assessment

Thank you for your interest in the workshop: Active Learning and Data-Driven Assessment! We will send a confirmation email prior to the workshop with additional details. We look forward to seeing you on November 16th, from 9:00 AM to 3:00 PM, at the Galesburg High-School Library.*This workshop is limited to the first 25 registrants so please register right away.
Name*

First NameLast Name
Email*
example@example.com
School*

Black Hawk CollegeWestern Illinois UniversityBushnell-West Prairie City CUSD #170Cuba #3 Fulton CountyMoline-Coal Valley School DistrictMacomb School District #185Galesburg CUSD #205Other School
Phone Number
Please enter a valid phone number.
Mark below all the options that describe your current position:*

Pre-Service TeacherIn-Service TeacherNOYCE ScholarLearning Assistant (LA)MAT StudentConference PlannerConference PresenterConference PanelistOther
Mark below all the options that describe your subject background:*

MathematicsScienceBiology/Life SciencesPhysics/EngineeringChemistryEarth SciencesSpace SciencesTechnology/EngineeringOther
Please list any dietary restrictions:
What is your preferred sandwich from Jimmy Jonh's?

The Pepe – ham, provolone, lettuce, tomato, & mayoBig John – roast beef, lettuce, tomato, & mayoTurkey Tom – turkey, lettuce, tomato, & mayoVito – salami, capocollo, provolone, onion, lettuce, tomato, & oil & vinegar, & oregano-basilThe Veggie – provolone, avocado spread, cucumber, lettuce, tomato, & mayo
Sandwich add-ons

CucumberYellow MustardHellmann's MayonnaiseJimmy PeppersSliced PicklesCrispy JalapenosCreamy Casear DressingJalapeno Ranch
Are you interested in receiving continuing education credits for attending?*

YesNo
How did you hear about this workshop?*

EmailFlyerColleagueWebsiteMy ProfessorOther
Will you need any type of accommodation? Please explain.
Please provide any additional questions or comments:
Your Cost of Attendance is
prevnext( X )
NOYCE STEM Teaching Workshop RegistrationThe registration cost covers lunch.
$20.00

Total

$0.00
Should be Empty:

STEM Teacher Workshop Registration: Active Learning and Data-Driven Assessment