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Registration is CLOSED!

Paper registration packets will be distributed on Friday April 5, 2002. Complete the registration form, or print this one, and return the signed form to Teresa Troxel, x3135, MS 99, by Friday April 19, 2002. Workshop assignment will be done on a first come, first serve basis. Confirmation of registration will be e-mailed to sponsors upon receipt and assignment of workshop.

GIRL

name: _______________________  age:_______  attended before? (circle) 94  95  97  99  00  01

special needs: _______________________________________________________________

All girls make the following  workshop choice (circle one)   set 1    set 2 

Girls 13 years and older, would you like to attend the video workshop? (circle one)  yes   no

SLAC SPONSOR

name: _______________________________________  relationship: ____________________

e-mail address: _________________ @slac.stanford.edu     work phone: ________________

Sponsors, would you like to be a volunteer workshop escort? If so, please circle.  AM   PM   both

ALTERNATIVE EMERGENCY CONTACT (On or Off Site)

name: _____________________________________________  phone #: ________________

PARENTAL CONSENT FORM

My daughter, _______________________________, has my permission to participate in "Take Our Daughters to Work Day" festivities on April 25, 2002.

Signed _________________________________    Date ____________________

(Can be signed by parent only.)

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Teresa Troxel 04-April-2002