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NATIONAL SCHOOL MODERNIZATION DAY SEPTEMBER 8, 1998 A live satellite teleconference featuring President Clinton. REGISTRATION FORM Please register your participation in this free teleconference by completing this form and faxing it to (202) 401-0689. Or, send an e-mail with all of the information below to: [log in to unmask] For information about the teleconference or questions about this form, please call (800) USA-LEARN. Yes! We plan to participate! (Check as many as apply.) We have a satellite downlink facility, and we will: ___host an event (We plan that approximately _____ number of people will attend our event.) ___tape the event for future use (___professional development? ___PTA meeting? ___other?) ___both We do not have a satellite dish, but we will call our local cable access television station and ask them to broadcast it:_____ Name & contact information at television station_______________________________________ Materials: All registrations received by August 28th are guaranteed to receive a participation package by September 4th with single copies of resources and other materials to help organize your event. Registrations received after this date will receive materials as soon as possible. Where will your event take place? Name of school/facility ________________________________________________________________ City____________________________________ State_________________________________ Who is going to organize your event? Where do you want materials sent prior to the event? Contact Name Organization/School Address Phone Fax (required!) E-mail Address Release information: Do we have permission to share your contact information with people in your community who may want to join your event and the news media? ____Yes ___No How did you hear about this teleconference? Or, what is your group affiliation? (Submission of this information has not been cleared under the Paperwork Reduction Act. Therefore, your response is optional.) _____ EDInfo _____ Public Education Network (PEN) _____ American Institute of Architects (AIA) _____ National Education Association (NEA) ____American Federation of Teachers (AFT) _____ Council of Great City Schools (CGCS) ____Rebuild America's Schools Coalition (RAS) _____Other?_______________________ Permission: Teleconferences produced by the U.S. Department of Education are in the public domain. Use, duplication and distribution are free and unrestricted. THANK YOU! -- +++++++++++++++++++++++++++++++++++++++++++++++++++++++++ Thomas G. Tate, ECS-CSREES-USDA, Room 3901 South Building Washington, D.C. 20250-0915 (v) 202-720-2727 (f) 202-690-2975 E-mail: [log in to unmask] ACE Home Page: http://www.sba.gov/ace ACE Monthly Meeting: 3rd Thursday Morning - 10 am - Noon 8th Floor Conference Room, 409 3rd Street S.W., Washington, DC ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++