| Employment Information |
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| Your Name: |
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| Title/Position: |
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| School District: |
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| School Name: |
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| School Address Line: |
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| City: |
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| State: |
Zip Code:
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| Office Phone & Ext: |
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| Office Fax: |
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| Email Address (Required): |
(Required) |
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| Personal Information |
This Information is Required for ACT48 Reporting: |
| Address Line: |
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| City: |
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| State: |
Zip Code:
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| Home Phone: |
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| Social Security # |
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| Registration Selection |
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Principals' Guide to Hiring Rescheduled from March 1 to Thursday, March 24, 2005 Registration Deadline: Monday, March 21, 2005 Cumberland-Perry Vocational Technical School Mechanicsburg, PA Registration 8:30-9:00 am, Program 9:00-12:15 pm, Lunch 12:30 pm |
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Member Rate, $100 |
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Non-Member Rate, $175 |
| Lunch |
Do you intend to stay for lunch (included in price)?
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Yes, I plan on staying for lunch. |
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No, I do not plan on staying for lunch. |
| Please Enter Purchase Order Information (If
Already Available) |
P.O. #:
Date:
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