GEBG Registration Form: HS Student Dialogues - US History 4/18/24
Topic:  US History Dialogue Series #2: How much influence should the Federal Government have over the country?
Date:  Thursday, April 18, 2024
Time: 1:30-2:15PM Pacific / 4.30-5.15PM Eastern / 10:30-11:15 PM Central European
Students: High School

*There will be at least one supervising adult in each breakout discussion room.*

**Make sure you have collected names, grade levels, and email addresses for the faculty participant/s and all student participants before completing this form.**
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Email *
Your First Name *
Your Last Name *
Your School/Work Email *
Job Title *
School Name *
School City
 *
School State/Province/Etc
 *
School Country
 *
Will you or your faculty member attend the optional “faculty lounge,” taking place 30 minutes prior to each student dialogue for faculty participants who might want to connect and discuss virtual exchanges and partnership possibilities?
 *
Will you be the participating adult from your school?
 *
Participating Adult's Name First and Last  (if different from the information above) *
Participating Adult's Title
Participating Adult's Email address
2nd Participating Adult First Name
2nd Participating Adult Last Name

2nd  Participating Adult Role/Title
2nd Participating Adult Email
3rd Participating Adult First Name
3rd Participating Adult Last Name
3rd Participating Adult Role/Title
3rd Participating Adult Email
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