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 Information


Dr. Jane Moore

EYH Conference Director
Professor of Mathematics
Phone: 817-531-4882
Fax: 817-531-4202
jamoore@txwes.edu

Contact Us:
1201 Wesleyan Street
Fort Worth, TX 76105

817-531-4444
Get Social: