REGISTRATION FORM

R

RE

EG

GI

IS

ST

TR

RA

AT

TI

IO

ON

N F

FO

OR

RM

M

Florida Department of Education

HIV/AIDS Prevention Education Regional Workshops

Promoting Prevention Together

Ft. Myers, September 8, 2005

Holiday Inn Select, 13051 Bell Tower Drive

8:00 a.m. – 3:45 p.m.

DIRECTIONS

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

to indicate your attendance plans. Return via fax by September 1, 2005 to:

(386) 312-2262 or mail it to:

Rachel Purcell, 3841 Reid Street, Palatka, Florida 32177

HIV/AIDS Coordinator

School Health Education Coordinator

Other School or District Professional

County Health Department Personnel

Other

Choose one session per time period.

?

(Place a checkmark in the block above the sessions you plan to attend.)

?

Concurrent Sessions

“Let’s Talk Sex” A Team Approach to Prevention

12:45 p.m. – 2:00 p.m.

HIV Update (Part I)

?

Best Practices and Teaching Strategies

Integrating HIV/AIDS Prevention Messages into

What’s All The HYPE?: H

IV

Y

outh

P

eer

Various Subject Areas

E

ducators

Concurrent Sessions

2:15 p.m. – 3:30 p.m.

“Let’s Talk Sex” A Team Approach to

Prevention

HIV Update (Part II)

Best Practices and Teaching Strategies

Integrating HIV/AIDS Prevention Messages into

Various Subject Areas

What’s All The HYPE?: H

IV

Y

outh

P

eer

E

ducators

Participant’s Name:

District/County:

Address:

City, State, Zip:

Telephone #:

Fax #:

E-mail address:

Please call us if you need any special accommodations at this meeting.

(Complete this form for each participant)

If you have any questions, please contact

Rachel Purcell (386) 329-3800 or