Elementary Lessons
School Registration Form

Please complete the following to register your school:

Name of District:
District IRN:
Name of Elementary School:
Building IRN:
Address:
City:	State: Zip:
Contact Name:
Contact Email:

How many students will have exposure to this program?
In what grades will the modules be used? Click all that apply: 3 4 5

Once you have completed this form, please go to the Listserv registration and sign up your teachers under the elementary school listserv to keep you up to date on all the latest information!

For information, contact:	Deb Lukjanovs (deb.lukjanovs@sinclair.edu)
	937-512-4516

Elementary Lessons School Registration Form

Elementary Lessons
School Registration Form