RISTA+2011+Registration+Form

**RHODE ISLAND SCIENCE TEACHERS ASSOCIATION ** **2011 SPRING CONFERENCE ** ** REGISTRATION FORM ** **Name:**_____________________________

**Local Address:** __________________________________________________________________________________


 * City:**____________________________________________ **Zip:** _________________________


 * E-mail:**_________________________________________________________________________________________


 * Local Phone Number**: ___________________________ **Type (Cellular, Home, Work): _____________________**

**School District:** ______________________________ **School:** _________________________________________

**Grade Level/ Content Area:**______________________

**RIDE Teacher Certification Number:** ___________________________________ **6 RIDE Credit Hours will be given to participants of this workshop **   **﻿**  **** PLEASE MAKE CHECKS PAYABLE TO RISTA. ****   ****  $  ** 40- Includes annual RISTA Membership  **  
 * //__Mail Registrations and fee to: __//**
 * Peter McLaren, Treasurer **
 * RISTA **
 * 112 Carriage Hill Road **
 * North Kingstown, RI 02852 **


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