Name of participant who will receive free application:
Name(s) of additional participant(s):
Name of contact person:
Mailing address:
City /Town:
Work Phone:
Evening Phone:
Fax:
Email:
Employer:
Applicants may apply for one session to showcase their topic. Sessions are scheduled for Thursday, October 20 from 8:30 am to 10:30 am and from 11:30 am to 1:30 pm, and on Friday, October 21 from 12:00 noon to 2pm.
Please indicate your first and second preference for your showcasing time:
___ Thursday 8:30 am-10:30 am
___ Thursday 11:30am to 1:30 pm
___ Friday 12:00 noon – 2 pm
Category of Showcasing Project
| ___Assessment | ___Child Care & Education | ___Collaboration | ___Curriculum |
| ___Family Involvement | ___Inclusion | ___Multicultural | ___Staff Development |
| ___Transition | ___Special Needs | ___Other: | |
Mail or fax the application form, the one page description and the brief summary to the address listed below by April 15, 2005. All applicants will be notified of their application status by the week of May 16, 2005.
Brian Michalski
The Center: Resources for Teaching and Learning
1855 Mt. Prospect Road
Des Plaines, Illinois 60018Phone: (847) 803-4381
Fax: (847) 803-2945
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