LSTA Region III Workshop July 16, 2019 Registration Form
LSTA Region III Workshop "Phenomena: The Enigma of Science Education" will be held Tuesday, July 16, 2019 at Terrebonne Parish Library - NORTH BRANCH located at 4130 W Park Ave, Gray, LA 70359 from 9:00-1:00 PM. Doors will open and sign-in will begin at 9:00 AM. This workshop is FREE to active members of LSTA. Inactive and non-members may register and pay their membership fee on-site (1 year membership is $15; exact cash or check will be accepted). Space is limited and will be first-come, first served.
Please complete the following information below to register for the LSTA Region III workshop.
If you have any questions, please contact LSTA Region III Representative, Tammy Brouillette at
Membership Status (check one)
1 year membership ($15), 3 year membership ($40) Membership forms are available online (
). Printed copies will be available at the workshop sign-in table.
Inactive member (need to renew and pay membership dues)
Non-member (need to complete new membership application and pay dues)
Other outside of Region 3
Grade Band You Teach or Role You Serve
Years teaching science
Please select any previous trainings you have attended addressing the LSS for Science. (Check all that apply.)
2019 Teacher Leader
Previous LSTA Workshop
LSTA/LATM Joint Conference Session
By typing your name below you understand you are registering for the LSTA Region III Workshop that will be held Tuesday, July 16, 2019 at the Terrebonne Parish Library - NORTH BRANCH located at 4130 W Park Ave, Gray, LA 70359 from 9:00-1:00 PM. Sign-in will begin at 9:00 AM.
(In the event you would like to un-register for the workshop, please contact Tammy Brouillette at
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Terrebonne Parish School District.