GEOSCIENCE ADVENTURES

 

WORKSHOP REGISTRATION FORM - 2017

Please indicate workshop(s) for which you are registering:

 

 

 


HISTORY OF LIFE

DATE: July 6 thru 8, 2017

 

 


Workshop Only No Housing Option

 


Field Camp - Single Occupancy Option

 


Field Camp - Double Occupancy Option

Double Occupancy with: _________________________________

NAME: ______________________________________________ Age:________

 

ADDRESS: __________________________________________________________

 

__________________________________________________________

 

PHONE: __________________________ E-MAIL: ________________________

 

SCHOOL YOU REPRESENT: _________________________________________

 

__________________________________________________________

 

GRADE LEVEL TAUGHT: ____________________________________________

 

Registration & Deposit of $100.00 per workshop (remainder of registration fee due first day of workshop)

 

Send Registration form and deposit to:

Geoscience Adventures

1802 US Highway 14 E

Shell, Wyoming 82441

 

Questions? --- e-mail: cliffmanuel84@gmail.com

 

Phone: (307) 765-2259 or

(866) 765-2259

Cell: (307) 763-0568