The New Jersey Council for History Education After School Seminar and Dinner
Registration Form
Wednesday, March 16, 2016 - 3:00-5:30 PM
Drew University - The Caspersen School of Graduate Studies
Mead Hall
STUDENT INFORMATION
Last Name: ______________________________________First Name: ________________________________________
Home address: _____________________________________________________________________________________
City: ___________________________________________________ State: _______________ Zip:__________________
Cell Phone: _____________________________________ Home Phone: _______________________________________
Email Address: _______________________________________________
School Name: ______________________________________________________________________________________
School Street Address: _______________________________________________________________________________
City: ___________________________________________________ State: _______________ Zip:__________________
ENROLLMENT
You will have time to attend two of three topics being offered. Please indicate your choice of two courses by numbering them
in order of your preference. We will try to assign you to the first two courses of your choice. Space is limited in each section.
We will confirm your registration and courses via email.
____ “An Gorta Mór”
____ “The Long Civil Rights Movement”
____ The Columbian Exchange
_____Yes, I plan to stay for light supper at 5:15 PM.
______No, I will not be staying for supper.
PAYMENT INFORMATION
Registration fee is $25.00
Please return form by March 11th and make checks payable to Drew University and mail with registration form to:
Drew University
Joanne Montross - NJCHE
Caspersen School of Graduate Studies,
SW Bowne Room 126
36 Madison Ave., Madison, NJ 07940
973-408-3285
[email protected]