Teacher Program Registration

PROFESSIONAL DEVELOPMENT
PROGRAM REGISTRATION

INSTRUCTIONS: This form is for professional development providers who wish to use the LIGO facility to convene a workshop.To request use of our facilities simply complete fields below, SUBMIT, then CLEAR FORM.
ORGANIZATION(S) PARTICIPATING : Facilitator Name(s) Mailing Address City State Zip Code Parish Cell # Phone # Email
GROUP INFORMATION: Grade(s) Taught Subject(s) Taught Number of Participants Have any of your teachers visited LIGO before? (Yes or No) Special Accommodations Need by Participants? (Yes or No) If yes, explain
DATE OPTIONS OF VISITATION: Due to high volume of visits, please schedule at least 6 weeks in advance. First Choice: Day of Week Date: Second Choice: Day of Week Date: Third Choice: Day of Week Date:	TIME OPTIONS OF VISITATION: Full day participants must bring lunch. Program Times
PROFESSIONAL DEVELOPMENT GROUP REQUIREMENTS: SEC facility and staff SEC facility only All drivers must be notified of the LIGO facility speed limit (UNDER 10 mph). Driving directions should be downloaded from our site in lieu of using search engines (i.e. mapquest); otherwise you will likely be miss-directed. All participants should complete a Video/Photo Release form. (OPTIONAL - If forms for each and every participant are not submitted upon arrival, photos of the group can not appear on our photo web page.) Questions / Comments:
COMPLETE REGISTRATION: To complete registration then . If you do not have email; print form for your records.