REGISTER HERE!

LogoWednesday, April 10, 2013

Complete this form and submit to register for the North Central PA Education Consortium held
at Bloomsburg University. We appreciate your participation and support!

Required fields denoted with an asterisk *
* Contact Person

* Email Address -- This is the e-mail address where ALL correspondence will be sent (confirmation, directions, parking, etc.).
* School District
* Mailing Address
Street

City State Zip

* Telephone
Area Code Number

Website


The cost of attendance for the Education Consortium is $75 for the first recruiter and $25 for each additional recruiter.

Please enter the total number of recruiters attending

* Rep 1: Rep 3: Rep 5:
   Rep 2: Rep 4: Rep 6:
*Will bring:
Freestanding Display Tabletop Display No Display
 
Please select the areas of certification sought: *
Art
Audiology
Bilingual/ESL
Business Ed.
Communications
Early Childhood Education
Elementary Education
English
Geography - Social Science
Guidance/Elementary
Guidance/Secondary
Health & Physical Education		 Interpreting and Sign Language
Languages - French
Languages - German
Languages - Latin
Languages - Russian
Languages - Spanish
Mathematics
Music
Reading
School Psychologist
Science - Biology
Science - Chemistry 		Science - Earth/Physical
Science - General
Science - Physics
Social Studies - Comprehensive
Special Education - Comprehensive
Special Education - Hearing Impaired
Special Education Supervisor
Speech Pathology
Technology Ed.
Other

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When ready, submit this form: