Registration for Taconic Hills Workshop – August 24to 28, 2015

To be held at: Taconic Hills High School – Craryville, New York

Name (please print clearly):

Home address:Street: City:

StateZipHome phone

SchoolName

School address:StreetCity

State Zip School phone

E-mail(working e-mail address required)

APPROVAL INFORMATION: A school administrator (principal, superintendent, dept. chair, etc.) must sign below to approve this teacher’s participation in this workshop. PLEASE NOTE:The administrator signature also signifies agrement to pay the $1000.00 fee for the workshop. The teacher must sign as a commitment to attend the workshop. Registrations without both signatures will not be accepted. Teachers must also sign the statement on the second page agreeing not to provide others with materials from this workshop.

Teacher Name (Printed) (Signature)

Administrator Signature Date

Administrator Name and Title (Printed)

For questions about the workshop, contact Leonard Behr by phone at: 518-672-5516 or

by e-mail at:

For questions about the University in the High School program, contact Debernee Privott

by phone at: 518-442-4148 or by e–mail at:

Registrations forms may be sent in via regular mail or by fax. Checks are to be made out to “The Research Foundation of SUNY”

If sending a paper copy by mail, send to:

Jessica Rae Lewis
UHS Offices - Biology 001
University at Albany
1400 Washington Avenue
Albany, NY 12222

If sending by Faxsimile, fax to:

Attn. Jessica Rae Lewis

(Fax #) 518-442-4135

We recognize the need to provide all of our instructors with a set of forms that can be used in conducting their research classes. The forms on our website and the materials provided in this workshop are provided for the use of teachers currently registered to teach in the University at Albany's Science Research in the High School Program. They are copyrighted by the Research Foundation of SUNY. We invite our teachers to use these files along with your own locally generated forms, or in place of them. Feel free to alter them to your local needs and copy them in any quantity you see fit, for as long as you wish. The only condition that we make is that you not supply them to others.All of the forms are password protected. If you are an instructor registered with the University in the High School program, you will be provided with the password to open them at the start of the workshop you attend.

As a workshop participant for the training "Teaching Science Research in the High School" I understand and agree to the above condition.

Signed______Dated ______