Presenter Registration Form

Expanding Your Horizons in Science and Mathematics
Workshop Presenter Registration Form

Saturday, March 28, 2015
Texas Wesleyan University, Fort Worth, TX

Please register before Jan. 15, 2015

Name:
 
 
Job Title or Department:
 
 
Employer:
 
 
Mailing Address:
 
 
City:
 
 
State:
 
 
Zip:
 
 
Office Phone:
 
 
Extension:
 
 
Cell Phone:
 
 
Fax:
 
 
Email Address:
 
 
Workshop title (short, catchy title that will generate interest in your field):
 
 
Short description of hands-on workshop:
Contact Us
Expanding Your Horizons

Dr. Jane Moore
EYH Conference Director
Professor of Mathematics
Phone: 817-531-4882
Fax: 817-531-4275
jamoore@txwes.edu

Office Hours

Monday-Friday
8 a.m.-5 p.m.

Contact Us:
1201 Wesleyan Street
Fort Worth, TX 76105

817-531-4444
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