Teacher Institute Registration Form

For the Annual Institutes at DEC Environmental Education Centers

Please print out this page, fill out the form correctly, and mail it back to the center where you want to attend the Teacher Institute (see addresses below).

Name:____________________________________________

Address:_________________________________________
____________________________________________________
____________________________________________________
____________________________________________________

Phone Number:____________________________________

E-mail Address:__________________________________

Grade Taught:____________________________________

School / Organization:___________________________

What do you hope to gain from this institute?
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________

Have you taken part in:

____ Project WET ____ Project WILD ____ Aquatic Project WILD

Institute on the Environment
Rogers EEC
2721 State Highway 80
Sherburne, NY 13460
607-674-4017

Hudson River Institute
Stony Kill Farm EEC
79 Farmstead Lane
Wappingers Falls, NY 12590
845-831-8780

Living Environment Institute
Five Rivers EEC
56 Game Farm Road
Delmar, NY 12054
518-475-0291