December 7-8, 2006 Workshop Registration

Name: ________________________________________________

Title: _________________________________________________

School District/Agency: ___________________________________

Mailing Address: ________________________________________

City/State/Zip: __________________________________________

Phone: ________________________________________________

E-mail: ________________________________________________

Check Number: _________
Purchase Order Number: ____________

Cost: $199 (includes materials, Thursday lunch and refreshments)

4 Easy Ways to Register

Phone: 715-261-1980, x 1995. Please have your purchase order number ready.

Fax: 715-261-1981. Fax purchase order and registration information.

E-mail: E-mail purchase order number and complete registration information

Mail: Send registration form, purchase order number or check payable to:

Marathon County Special Education
Attn: Kathy Matthaidess
1200 Lakeview Drive, Suite 350
Wausau, WI 54403

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