Gallaudet University and Laurent Clerc National Deaf Education Center GLOBE Partner
GLOBE Training at Gallaudet University
Teacher Training Workshop Registration      July 26-30, 2004
(Workshop acceptance is on a first come/first served basis,  up to 12 participants.)

Teacher Name:   ___________________________________________________ 
Home Address:   ____________________________________________
        Phone/TDD #:   (____)____________FAX# (____)_________________
        Email Address:  ________________________________________________ 

School:         ______________________________________________
       School Address: _____________________________________________
       Phone/TDD #:   (____)_____________School FAX #:  (____)__________
       Email Address:   _____________________________________________
              (Please check the address you prefer to use for GLOBE correspondence.)

How did you learn about our GLOBE Teacher Training Workshop?
    ____ email  (list serve? ____________  )                ____   the Gallaudet GLOBE Partner web site
    ____  another teacher who trained at Gallaudet       ____   the GLOBE Program (www.globe.gov)
    ____  my administrator                                            ____   other:  _______________________

Training fees:
Registration:                                    ___  $100 per teacher registration fee
Materials, Food and Lodging Fees:  (Includes training materials, dormitory room and meal ticket)
       US Citizens:                             ___ $250    Provided through Space Grant funds

       International Participants:           ___ $250
                                                          ___ $400  Optional GLOBE equipment kit