Mathematics Educator Appreciation Day Conference
Saturday, January 30, 2010
Co-Presenter Form

Co-Presenters:
This form is for those who are presenting with someone who has already submitted the session title, topic, and requirements. We plan to prepare nametags and packets for all presenters so we need to have the following information.
Please fill in the information below. Use a mouse click or the tab key to move to the next item. Select "Submit" to process your form for Mathematics Educator Appreciation Day to be held on Saturday, January 30, 2010.
We appreciate your willingness to share your expertise.
Please submit your information as soon as possible, but no later than December 1. We plan to prepare packets well ahead of time.
First Name:
Last Name:
Home Address:
City:
State:
Zip Code:
Email address:
A valid email address is required to process this form.
Work Phone Number:
Home Phone Number:

Select your school district, or other affiliation from the drop-down menu.

School:

Lunch will be provided free of charge at the University Park Marriott following the last session. Do you plan to attend the luncheon? (Please select one.)
Yes
Yes, and I prefer a vegetarian option
No

Co-Presentater Contact:

Name the person who submitted the Presentation Title and information.

Additional Comments:

The data will take approximately 1 minute to process. You will receive a "Thank you" message once it is completed.
Do not work on other applications while the data is being transferred since that will terminate the process.


Presenters are asked to bring necessary materials and handouts for 30 participants. If this is a problem, please contact Sue Adams at adams@math.arizona.edu.
Thank you!


If you experience difficulties completing the online form, please print it out. Complete it and mail it to the following address:

Sue Adams
Department of Mathematics
The University of Arizona
617 N. Santa Rita Ave.
P.O. Box 210089
Tucson, AZ 85721-0089