REGISTRATION FORM

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2003 Florida Coordinated School Health and

Safe and Drug-Free Schools Coordinators’ Meeting

DIRECTIONS

Please complete the information form below and check the appropriate box(es)

to indicate your attendance plans. Return via email no later than September 4, 2003 to:

CSHPRegistration@fldoe.org

(STEP 1-Complete the form, STEP 2-Click File, then click on Send To,

STEP 3-Type in the email address listed above, STEP 4-Click Send)

Or print the form and FAX it to: (850) 245-9957, or mail it to:

Debra Betton, CSHP-FEC 501, 325 W. Gaines St., Tallahassee, FL 32399

District/County:

SDFS Coordinator

School Health Education Coordinator

Other School or District Professional

County Health Department Personnel

This is my first year in this job.

PRE-CONFERENCE:

Safe and Drug-Free Schools

School Health

Safe and Drug-Free Schools

Advisory Council Members

Advisory Councils (SHAC)

New Coordinator Orientation

September 29, 2003

September 29, 2003

September 29, 2003

Monday, 1:00 – 4:30 p.m.

CONFERENCE:

POST-CONFERENCE:

September 30 – October 1, 2003

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Tuesday, 8:00 a.m. – 5:30 p.m.

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Wednesday, 8:00 a.m. – 12:00 p.m.

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Department of Children & Families

Florida Youth Substance Abuse Survey

Overview

October 1, 2003

2003 Coordinators’ Meeting

Wednesday, 1:00 – 4:00 p.m.

Participant Name:

Job Title:

Address:

City, State, Zip:

Telephone #:

Fax #:

Email address:

(Complete this form for each participant)

Tonya Milton at (850) 922-9056/SunCom 292-9056

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