Registration Form for May 9-11 2012 Master Teacher Program
Fee: US$ 1055 per faculty member
Name

Academic Rank

Department

University

Address



Telephone

E-Mail Address



Contact Ms. Ellen Ascher, Program Administator, for space availability.

Hotel Information:
Springhill Suites by Marriott / Buckhead
1-888-287-9400
Mention the Georgia State University Master-Teacher Program

To Register: Make check payable to MASTER TEACHER PROGRAM.



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