Think! Energy Workshop Interest Form

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DTE Energy, Consumers Energy, SEMCO ENERGY Gas Company and Lansing BWL are hosting FREE 6 hr workshops with a $100 stipend, 5 SCECHs and $50 in free materials for teachers. These workshops are best suited for grades 3-5. If you are interested in attending, complete the brief form below and more information will be sent to you. Lunch is provided.

Your Name *

Location interested in attending *

All workshops run from 9-3, lunch provided. Please choose the location closest to your school so your sponsorship can be secured from your energy providers. NOTE: The Detroit workshop is full, but we often have people drop out, so you may register for the wait list and we will move people in as space allows when we confirm attendance.

Battle Creek, November 16 - Courtyard by Marriott, 12891 Harper Village Dr.

I can't attend, but please keep me informed of other opportunities

Required

School Name *

School City/Township (must be served by a participating company) *

Email Address *

Phone Number (only used for last-minute changes/updates) *

Grade level assignment for 2019-20 *

2/3

3/4

4/5

5/6

Other:

If you were referred by someone, please provide their name.

Any special dietary needs for lunch?

(Vegetarian, vegan, gluten free, nut allergy, etc.)

Anything else we should know?

Preference for $100 stipend delivery after workshop *

Amazon e-gift card (sent to email address listed above)

Check (made out to you, not your school)

Address for mailing $100 stipend check (if check selected above) - include city & ZIP

Submit

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