Educator Trek Registration Form |
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| Registration for most Educator Treks is on a first-come, first-served basis. Treks fill quickly, so register early. To register, print, complete and mail Educator Trek Registration Form and deposit check to: Mike Dunn, Coordinator of Teacher Education N.C. Museum of Natural Sciences 11 West Jones Street Raleigh, NC 27601-1029 |
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Participant Information Name ______________________________________________________________________ Home Address _______________________________________________________________ City _____________________________________ State ________ Zip __________________ Phone H (_____)_______________________ W (_____)______________________________ E-mail H ________________________________ W __________________________________ Emergency Contact Name _______________________________________________________ Emergency Contact Phone Number ________________________________________________ School/Organization ___________________________________________________________ Grade/Age Taught ____________ School County ____________________________________ My reason(s) for wanting to participate in the Museum's Educator Trek(s): |
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| Trek # |
Trek Title |
Trek Cost* |
Deposit** ($20/Trek) |
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Friends of the Museum teacher members receive
a 15% discount Make check payable to: Museum Extension Fund |
Deposit Subtotal |
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MINUS Friends 15% Discount |
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DEPOSIT TOTAL |
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** Registration deposit is non-refundable upon acceptance in program. Refunds on the balance of Trek Cost will be granted only when cancellation is received at least two weeks before the beginning of the trek. Cancellations must be made in writing.