2008 SETA Registration Form

Registration Fee $12.00

http://education.csm.edu/sean/seta/

(If your presentation is selected, you will be refunded your registration fee at the door upon admission.)

Name: _______________________________________________________

Email address (required):________________________________________

Address: _____________________________________________________

City: ___________________ State: _________________ Zip Code:_______

Phone Number: ________________________________________________

Institution: _____________________________________________________

Are you (check one):

           Student:___________

           Faculty:____________

           K -12 Teacher:____________

Do you want to present?   Yes _______    No ______

If yes, please give a summary of your presentation: (please fill out full presentation form)

____________________________________________________________

____________________________________________________________

____________________________________________________________

(Registration fee will be waived or refunded at the door upon admission for presenters.)

Do you want to be considered for a NETA Scholarship?   Yes____      No_____

T-Shirt Order

(100% cotton, short-sleeve, adult sizes, vibrant colors)

CHECK size for color choice:

Checks payable to College of Saint Mary

Send to:                                                                             Prices:                                                                                          

College of Saint Mary                                                        $10.00     S - XL

Attn: Dee Acklie .Ph. D.                                                    $10.00     2X & 3X

7000 Mercy Road

Omaha, NE 68106

COLLEGE OF SAINT MARY                            Back to SEAN