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FORMS

medical release, EYH brochure 2015 (double sided) - workshops, paper registration, schedule
                         folleto en español (dos lados) - talleres, documento de registro, programar
Enrollment is limited and will be filled upon receipt of registration on a first come first-served basis. To increase your chances of getting the session you want, early registration is strongly advised.

In keeping with the theme "Expanding Your Horizons," you will be assigned to one workshop that you did not pre-select. Your $15.00 registration fee covers all conference materials and lunch. If the $15.00 registration fee is preventing you from attending this workshop, please see your teacher about scholarship possibilities.

Logo t-shirts are available for an additional $15.00. If you need more information call Dannica Price at (509)963-2135 or email cesme@cwu.edu.
 
REQUIRED: I have read and give publicity consent to CWU per the policy below. **
Do you have any allergies? yes no       If yes, please explain
 
First Name:*      Last Name:*      School:*      Grade:*      Email*:
  Phone*:         “Home Address:*      City & State:*       Zip:*
 
select one choice from each list below.

Send check in the mail to:

Center for Excellence in Science and Mathematics Education / MS 7540
Central Washington University
400 East University Way
Ellensburg, WA 98926-7540

First
Second
Third
Fourth
Fifth
 

Group Registration Additional Required Information (To Be Completed for School Groups Only)

Group Leader name: (Please use the same leader name for each group consistently)

Please call (509)963-2135 to confirm payment options.

 
 

*REQUIRED
**I give my consent for the CWU EYH Conference to use photos, videos, and/or audiotape that includes my child for the purpose of publicizing and promoting Expanding Your Horizons. I understand that the images or voice recordings may be published in newspapers or magazines, on the World Wide Web, or be broadcast on television or radio.

THE REGISTRATION DEADLINE is 4:00 pm, February 13, 2015

Requests for reasonable accomodations should be made at 509-963-2205 or TDD 509-963-2207

 

Required: Payment method

Please select one option below

STEP 1

Open up https://www.mycentral.cwu.edu/EYH and pay securely online. A new window opens.

Complete the payment process. When payment is completed, close the new window.

Then, Select the "paid now" radio button below.

STEP 2
paid now using the link in step 1 above
OR
payment mailed
If you would like to add a $15 t-shirt please select your size: YM YL YXL S M L XL
 
 
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