Student Registration

1. Complete the registration form on-line.
2. Print two copies of the completed form using the print button at the bottom of the form.
    (one copy to mail and one copy for your records)
3. Mail the signed copy with a check or money order for $15.00 per girl payable to:

GEMS, c/o Registrar: Mary Birdsell
103 Crestview Dr. Wood River IL 62095.

The cost, which is non-refundable, includes workshop materials, snacks and a T-shirt.
Scholarships are available but must be processed through the girl's teacher
First Name:
Last Name:
Phone:
Address:
City:
State:
Zip:
School:
Email:
Grade: 6th   7th   8th   Home Schooled  
Previous Attendance: First Time   1 yr   2 yrs  
All girls will be enrolled in "Welcome to the Real World" as 1 of their 3 workshops. List 3 workshops from the "Workshops" page that you would enjoy attending. One workshop will be one of your choices; the other will be assigned.
Special Needs:
Comments/Instructions:
Workshop Choices:
Please do not include
Welcome to the Real World 		1.
2.
3.
     
Parent/Adult/Teacher Registration

1. Complete the registration form on-line.
2. Print two copies of the completed form using the print button at the bottom of the form.
    (one copy to mail and one copy for your records)
3. Mail the signed copy with a check or money order for $15.00 attendee (parents, grandparents, and other concerned adults) payable to:

GEMS, c/o Registrar: Mary Birdsell
103 Crestview Dr. Wood River IL 62095.

The cost, which is non-refundable, includes workshop materials, snacks and a T-shirt.
5 CPDU's will be available for Teachers.

Title:
First Name:
Last Name:
Phone:
Address:
City:
State:
Zip:
Email:
Previous Attendance: First Time   1 yr   2 yrs  
Special Needs:
Comments:
    
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