FLORIDA DEPARTMENT OF EDUCATION

 

FITNESS, FUN, FOREVER:

GAMES AND FITNESS ACTIVITIES FOR ANYTIME

 

PARTICIPANT REGISTRATION FORM

 

 

PLEASE MARK DESIRED LOCATION:

October 6, 02 – Tallahassee

November 2, 02 – Miami

November 23, 02 – Orlando

 

FIRST

NAME:

LAST

NAME:

 

JOB TITLE:

 

 

EMPLOYER:

 

WORK ADDRESS:

(city, state, zip)

 

 

 

 

 

PHONE:

 

FAX:

 

EMAIL:

 

 

 

PLEASE LET US KNOW IF YOU REQUIRE ANY SPECIAL ACCOMMODATIONS AT THE MEETING:

 

 

 

 

 

 

 

PLEASE RETURN BY SEPTEMBER 16, 2002 TO:

 

DEPARTMENT OF EDUCATION

COORDINATED SCHOOL HEALTH PROGRAM

325 W. GAINES STREET

◆

SUITE 501

TALLAHASSEE, FL 32399-0400

ATTN: DEBRA BETTON

OR