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SAILN STRAND LCTL - Registration Form & Payment
Please complete the following form by September 12th
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* Indicates required question
1. First Name
*
Your answer
2. Middle Name (Mark NA if you don't have a middle name)
*
Your answer
3. Last Name
*
Your answer
4. School
*
Your answer
5. Email address
*
Your answer
6. Phone number
*
Your answer
7. Level of experience (how many years have you been teaching?)
*
0-3
4-5
6-10
11-15
16+
Other:
8.Gender
*
Male
Female
Prefer not to say
Other:
9. Zip Code (Home)
*
Your answer
10. Ethnicity
*
White
Black or African American
American Indian or Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Prefer not to say
Other:
11. Mailing address
*
Your answer
12. Do you need special accommodation? if yes, please email us at
larc.sailn@sdsu.edu
after submitting this registration form.
*
yes
No
13. Language(s) you are teaching
*
Arabic
Chinese
Urdu
Hindi
Persian
Pashto
Russian
Hebrew
Other:
Required
14. Which one best describe the type of school your work at?
*
Public
Private
Charter
Online
Other:
Required
15. What grade level(s) do you teach?
*
Your answer
16. I would like to apply for Stanford professional development credits (10 hours = 1 quarter unit credit/ cost is $100 check to be sent prior to start of workshop) - check will be made to the order of Stanford University
*
yes (you will be sent a separate email with information)
no
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