Regional Leadership Training Workshop Registration Form September 26, 2008 PTEC - St Petersburg

School _______________________________________________________________ Advisor _______________________________________ $ 10.00 per person / includes lunch Advisor _______________________________________ $ 10.00 per person / includes lunch Advisor _______________________________________ $ 10.00 per person / includes lunch Please list students attending and bring this form and money to the workshop.  Student Name 1  __________________________________________________________ $ 10.00 2  __________________________________________________________ $ 10.00 3  __________________________________________________________ $ 10.00 4  __________________________________________________________ $ 10.00 5  __________________________________________________________ $ 10.00 6  __________________________________________________________ $ 10.00 7  __________________________________________________________ $ 10.00 8  __________________________________________________________ $ 10.00 9  __________________________________________________________ $ 10.00 10 __________________________________________________________ $ 10.00                     TOTAL AMOUNT ___________

I M P O R T A N T Please Call, FAX, or email the number of students attending from your school. Send to: Jerry Ditty, Supervisor Industrial, Technology & Agribusiness Ed. Administration Building 301 4th Street SW Largo FL 33770 Office (727) 588-6204 Fax (727) 588-6007 District Cell (727) 638-2501 Email Jerry Ditty        Email Tonya Ditty

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