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A Day of Deliberative Dialogue School Registration
Please complete the form below to register.
INFORMATION
Name
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First
Last
Phone
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Teacher Email
(Required)
Institution/Organization Name
(Required)
Job Title
(Required)
Anticipated number of student participants (10-15 students in one cohort):
(Required)
Grade Level(s)
(Required)
Grade 9
Grade 10
Grade 11
Grade 12
PAYMENT
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One Student Cohort (10-15 students)
Total
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Year
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By signing below, the undersigned indicates that it has the legal authority to enter into this Enrollment Agreement on behalf of Participant School, as defined herein, and that it has read and fully consents to the
Terms and Conditions
outlined in this Agreement.
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