PEARL RIVER VISIT TRAINING ENROLLMENT FORM

Please provide the following information for each individual you are nominating to participate in the two-day Tri-State visit team training session on November 18 and 19 at Pearl River High School, Pearl River, Rockland County, NY. Submit it using the button at the bottom of the form. Registration will be confirmed with individual e-mail messages providing participants with details about the training and driving instructions.

Name                   

District                    

Title or Position    

Level:            Elementary  Middle School  High School  District  

Specialty: (Check all that are relevant):

      Mathematics   Science   Writing/English/Language Arts   Social Studies

      Special Education      Other (please specify):    

School Name          

School Address       

City/State/Zip          

School Phone         

School Fax             

E-mail                      

Home address         

City/State/Zip          

Home phone