Thank you for using the Scholastic On-Line Registration Process.  This system allows you to register for any product trainings/workshops/events being offered in the Farwest Region at this time.  You will receive a confirmation once you have completed the form provided.  If you have any questions, you can contact your regional office at: 800-342-5331.  Thank you for your registration, we look forward to seeing you.
Required information is shown in boldface type and is preceded by an asterisk (*). All other information is optional. Our privacy policy is available for your review.

First Name*
Last Name*
Title*
School Name
Address*
Address Line 2
District Name*
City*
State*		Choose One Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip/Postal Code*
School Phone Number*		- -
Email Address*
Email Address again for verification*
Grade(s)*
Purchase Order #
Conference Name*		Select One HAWAII ONLY - READ 180 Seminar 2 Dec 2, 2009 HAWAII ONLY - READ 180 Seminar 3 Feb 3, 2010 HAWAII ONLY - READ 180 Seminar 3 Feb 4, 2010 HAWAII ONLY - READ 180 Seminar 4 Apr 7, 2010 HAWAII ONLY - READ 180 Seminar 4 Apr 8, 2010 HAWAII ONLY - READ 180 Seminar 4 Apr 9, 2010 Hawaii ONLY In Class Support February 2, 2010 Hawaii ONLY In Class Support April 6, 2010 Fresno COE READ 180 EE Follow-Up Training Dec 8 Fresno COE READ 180 CA Follow-Up Training Dec 9 Alameda COE READ 180 EE Follow-Up Dec 3 Santa Clara READ 180 EE Follow-Up Training Dec 15 Santa Clara READ 180 CA Follow-Up Training Dec 16
Sign up additional people		Select One 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Name 1  

Name 1 Title

Name 2  

Name 2 Title

Name 3  

Name 3 Title

Name 4  

Name 4 Title

Name 5  

Name 5 Title

Name 6  

Name 6 Title

Name 7  

Name 7 Title

Name 8  

Name 8 Title

Name 9  

Name 9 Title

Name 10 

Name 10 Title

Name 11 

Name 11 Title

Name 12 

Name 12 Title

Name 13 

Name 13 Title

Name 14 

Name 14 Title

Name 15 

Name 15 Title

Name 16 

Name 16 Title

Name 17 

Name 17 Title

Name 18 

Name 18 Title

Name 19 

Name 19 Title

Name 20 

Name 20 Title