Professional Development Registration Form

2024-2025 S.E.E.A.C Teacher Workshops:

All workshops are on a Saturday mornings for an opportunity to receive 17 ACT 48 hour by the end of the school year (all hours will be reported at the conclusion of the workshops series in May).

First Name*

Last Name*

PPID#

Teacher/Service Provider*

Teacher
Service Provider

Subject*

Your school or organization

Home Address*

City*

State*

Zip Code*

Phone*

Email*

Prefered Contact Method*

Telephone
E-mail

Available Workshops:

May 17th, 2025 –9:00 AM – Noon @ ALCOSAN ~ Activity Assembly

Photos/Videos taken during this event may be published to ALCOSAN’s website, social media, or other media. As consideration for participation in this event and by clicking this box, you consent for photos/videos of your child to be used in ALCOSAN’s marketing or promotions and without compensation.

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Signature (please sign as example "/s/ first name last name")

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