Registration Teachers Workshop

Use this form to register for the 2018 Illinois Teachers Workshop: Rocks, Minerals & Mining in Today’s Society.

You will be asked to select a form of payment on the next screen. Alternatively, you may register by mail by downloading the paper form here.

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Choose One *

I am registering at a cost of $60 and wish to receive Professional Development credit (or no credit). I am registering ($60) and will pay now to receive 2 graduate credit hours for GEO 493.07, “Geology of Illinois: Teaching, Rocks, Minerals & Mining in the Classroom” from Illinois State University at a cost of $250. I am registering ($60) and wish to receive grad credit but I will pay the grad credit course fee when I arrive at the workshop.

Name *

First

Last

Street address *

City *

State *

Zip code *

Your daytime or cellphone number *

Email address you will use during the summer *

Choose One *

You may share my email address with other participants Keep my email address private

T-shirt size *

School *

City or town where school is located *

Grade / Subject *

Your Illinois Educator Information Number (IEIN) *

Name of teacher you will share a room with *

How did you hear about the workshop? *

Choose how you wish to pay for registration *

Credit card Check mailed to IAAP

Submit

Workshop will be held at
Western Illinois University - Olson Hall
400 N Western Ave.
Macomb, IL 61455