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2021-2022  Alaska Academic Pentathlon Registration Form

Topic: Water: A Valuable Resource

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Name of School *
School District *
Coach(es) Name - please list all names and contact information (email and phone). *
Anticipated Number of Students for Licensing Purposes (the cost is included in the participation fee) *
School Mailing Address *
City *
State *
Zip Code *
School Phone *
School Enrollment (approximation) *
Contact Number and Title of Person Filling out this Form *
The coach or coaches of our school 's Pentathlon program are interested in participating in the UAA 500-level Coach course. This course will take place from October 19-January 18. Coaches are responsible for paying all associated UAA fees for this course (@$119) unless funding is available. *
Please list the coaches names interested in taking the UAA course, the subjects they teach and contact information (email and phone).   *
The cost of the Alaska Academic Pentathlon program is $450 per team. This fee covers participation fees and the cost of the curriculum. Please list the name of the person who should receive the invoice along with a snail mail and email address. *
Questions? Comments? Please contact Joan Pardes at 907-586-6806 x 418 or joanp@serrc.org
The Alaska Academic Pentathlon is a program of SERRC - Alaska's Educational Resource Center
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