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Academic Year 2005 - 2006 Form

Participant Form

 

Return by April 18, 2005 to:
Barbara Beyerbach
Swetman Hall SUNY Oswego
Oswego, NY 13126

________I will Participate in SMART

________I will NOT participate in SMART

Name_________________________________________________

Address_______________________________________________

Home Phone ___________________________________________

Email__________________________________________________

School Address_________________________________________

School Phone___________________________________________

Teaching Subject and grade level_________________________

Current Team:

Delaware__________________________________________

Huntington________________________________________

Henninger­_________________________________________

Onondaga Nation____________________________________

New York City______________________________________

YALG_____________________

Healthworks_________________________________________

Oswego County (specify GESA, PDS, Teacher Work Sample, other)

ETE Exchange_________________________________________

 

Other_______________________________________________