ETTC Information:

Who is your local ETTC:    VSU HGRESA WGA Pioneer RESA

First Name:   Last Name:

Position/ Title:

School:

School System:

Street Address:

City:Zip Code:

Work Phone --       FAX --   

Email:
                        

    Did you attend the 2007 Facilitator's Training? Yes  No 

    Have you ever attended a Facilitator's Training at your local ETTC?Yes  No

    How many years have you facilitated a PROMOTE Team?  Never 1-2 Years 3+ Years

Co-Facilitator Information (If Applicable)

First Name    Last Name    

Position/Title

Email
                     

    Did you attend the 2007 Facilitator's Training?Yes  No 

    Have you ever attended a Facilitator's Training at your local ETTC?Yes  No  

    How many years have you facilitated a PROMOTE Team? Never 1-2 Years 3+ Years

Team Information
(A team consists of 3–8 student members and no more than two facilitators.)

    Team 1:     Team Division 2nd-3rd Grade 4th-5th Grade 6th-8th Grade 9th-12th Grade
    Student Team Members (Check Spelling)

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     Team 2:     Team Division 2nd-3rd Grade 4th-5th Grade 6th-8th Grade 9th-12th Grade
      Student Team Members (Check Spelling)

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            7.             8.

    Team 3:    Team Division 2nd-3rd Grade 4th-5th Grade 6th-8th Grade 9th-12th Grade
    Student Team Members (Check Spelling)

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    Team 4:     Team Division 2nd-3rd Grade 4th-5th Grade 6th-8th Grade 9th-12th Grade
    Student Team Members (Check Spelling)

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