Middle Level Sam Houston (July 9-13, 2023)

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Advisors, you will need to fill in this form for EACH individual advisor and student attending the workshop. For example: Complete this form for the advisor and submit, and then complete for each student separately and submit. You will also complete the advisor/student registration forms to be submitted at summer workshop check-in. This must be filled out even for those on staff. This will be used to do room assignments and small group assignments. I must have these filled out and sent in no later than Friday, June 30th. Please call me at 4093819212 or email me (vlong@deweyvilleisd.com) if you have ANY questions. Thank you! - Vicki

School Name *

Registering a(n): *

First Name *

Last Name *

Grade level going into *

Has this person attended a TASC summer workshop before? *

Gender *

Cell phone # for advisor/student registered - please give the correct one, it helps if you do and not just put the advisor's for all of it

Any special dietary needs (fill in if needed)

Any special medical needs (fill in if needed)

Any special circumstances that it would be helpful for the director or consultant to be aware of (fill in if needed)

Submit

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