RISTA+2011+Regustration+Form

 ** RHODE ISLAND SCIENCE TEACHERS ASSOCIATION **  ** 2011 SPRING CONFERENCE **  ** REGISTRATION FORM  **   Name: __________________________________________________________________________________   Local Address: __________________________________________________________________________   City: ______________________________________________  ** Zip: _______________________ **
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  E-mail: ________________________________________________________________________________  <span style="font-family: 'Perpetua Titling MT',serif; font-size: 19px; line-height: 28px; text-align: left;"> Local Phone Number: _________________________ Type (Cellular, Home, Work): __________________ <span style="font-family: 'Perpetua Titling MT',serif; font-size: 19px; line-height: 28px; text-align: left;"> <span style="font-family: 'Perpetua Titling MT',serif; font-size: 19px; line-height: 28px; text-align: left;"> School District: ________________________________ School: _________________________________ <span style="font-family: 'Perpetua Titling MT',serif; font-size: 19px; line-height: 28px; text-align: left;"> <span style="font-family: 'Perpetua Titling MT',serif; font-size: 19px; line-height: 28px; text-align: left;"> Grade Level/Content Area ___________________ <span style="font-family: 'Perpetua Titling MT',serif; font-size: 19px; line-height: 28px; text-align: left;"> <span style="font-family: 'Perpetua Titling MT',serif; font-size: 19px; line-height: 28px; text-align: left;"> RIDE Teacher Certification Number: _____________________________ <span style="font-family: 'Perpetua Titling MT',serif;">  ** <span style="display: block; margin-bottom: 0in; margin-left: 0in; margin-right: 0in; margin-top: 0in; text-align: center;"> <span style="color: black; font-family: Arial,sans-serif; font-size: 10pt; line-height: 150%;">RIDE Credit Hours will be given to participants of this workshop **   ** PLEASE MAKE CHECKS PAYABLE TO RISTA. **   ** $ ** 40- Includes annual RISTA Membership
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//__<span style="font-family: 'Times New Roman',serif;">Mail Registrations and fee to: __//

<span style="font-family: 'Times New Roman',serif; font-size: 14pt;">Peter McLaren, Treasurer <span style="font-family: 'Times New Roman',serif; font-size: 14pt;">RISTA <span style="font-family: 'Times New Roman',serif; font-size: 14pt;">112 Carriage Hill Road <span style="font-family: 'Times New Roman',serif; font-size: 14pt;">North Kingstown, RI 02852

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