Florida Department of Education

Request for Applications (RFA) Technical Assistance Meeting to become an SES provider for the 2009-2010 School Year

Enter the contact information requested below. The contact information should be that of the individual registering for the meeting. Registrants with multiple participants are required to register each individual that will be in attendance using a different e-mail address each time.

Please note that registration is limited to 700 participants. You must register via the online registration system as onsite registration will not be available. There is no registration fee to attend.

Registration will close December 31, 2008 5:00 PM EST.

Name and Organization should be entered exactly as you wish it to appear on your name badge.

Questions? Contact Anna Moore at: Anna.Moore@fldoe.org.

Please fill in the information below.
Fields marked with an * are required fields.

Prefix

First Name

Last Name

Suffix

Organization Name

Address

* Address 1
Address 2
* * *
City

State

Zip (xxxxx-xxxx)

Phone Number

* (xxx-xxx-xxxx)

Phone Extension

Fax Number

* (xxx-xxx-xxxx)

E-mail

Confirm E-mail

Please select the workshop(s) you would like to attend

	Request for Applications (RFA) Technical Assistance Meeting to become an SES provider for the 2009-2010 School Year January 15, 2009 Seats Available: 128 out of 700 Registration Deadline: January 9, 2009

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