Wait List: Build-A-Drifter Workshop - January 28, 2019
Form to be placed on the waiting list for the 2019 Build-A-Drifters professional development workshop at the MCPSS Environmental Studies Center. Please complete the form below in its entirety. Should space become available, you will be contacted to complete the registration process.  
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Applying for enrollment in the following session *
Full Name *
Preferred name
Email Address (please list preferred and secondary) *
Cell Phone *
Home Phone
Which number is best to contact you?
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Name of School / Institution *
Grade Levels Taught *
Classes Taught *
School Phone *
School Street Address *
School City, State, Zip Code *
School County *
School Website *
Home Street Address *
Home City, State, Zip Code *
Home County *
Are you interested in potentially involving your students in a drifter deployment in Mobile Bay? *
Required
Are your students allowed to take a field trip on Dauphin Island Sea Lab boats? *
Required
Indicate any dietary restrictions, needs, or allergies, or any medical conditions or disabilities requiring accommodation (please list) *
How did you hear about our program? *
This workshop is FULL. Should space become available, you will be contacted to complete the registration process.
All checks should be made payable to Dauphin Island Sea Lab and mailed to:
DHP Workshop
Dauphin Island Sea Lab
101 Bienville Blvd
Dauphin Island, AL 36528

Print this form BEFORE submitting. Upon submission, the form is no longer accessible to you. You can either print a hard copy of this form, or print to PDF in order to save for your records.
Program Information
Discovery Hall Programs reserves the right to cancel the program in the event enrollment is inadequate. $25 registration deposit may be returned if notice of withdrawal is communicated to the DHP Registrar (in writing) at least seven days prior to the workshop, and we are able to fill your space.  Please add sejohnson@disl.org and DHPSummer@disl.org to your email address book. Please retain a copy of this form for your records.
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