2019 Southeast Worlds of Work School Registration
The Southeast WOW Education Committee is making plans to schedule schools to attend Southeast WOW, which will be held February 20 and 21, 2019 at the National Peanut Festival Fair Grounds in Dothan. Please provide the information included in the registration form for your school.
Please submit the school registration form no later than Friday, November 16, 2018. For further information or questions, call Amanda Hardy at (334) 796-7785.
IMPORTANT NOTE: Once all school registration forms are received, each school will be assigned a date and time to attend the event. Do not make travel plans or notify the school CNP Director until your school receives the official notice of your specific scheduled date and time. Notifications will be sent by mid-December.
Name of School *
Your answer
Name of School System *
If Private or Home School, please indicate that.
Your answer
City *
Your answer
State *
County *
School Start Time *
*Report all times in Central Standard Time*
Your answer
School End Time *
*Report all times in Central Standard Time*
Your answer
Approximate Travel Distance to Event Location *
*Report in number of miles
Your answer
Approximate Travel Time to Event Location *
*Denote HH:MM - Ex: 30 minutes = 00:30; 1 hour and 20 minutes = 01:20
Your answer
Required time of day buses must be back on campus to run daily routes *
*Report all times in Central Standard Time*
Your answer
Number of 8th-graders planning to attend *
Your answer
Number of Teachers, Staff, and Chaperones planning to attend *
*Recommended one chaperone per every 20 students. Chaperones may be, teachers, administrators, responsible parents or guardians and community leaders
Your answer
Number of School buses *
Your answer
Are there any special accommodations that need to be made for your school or students? *
Examples Include: physical disabilities, allergies and health issues, etc.
Your answer
Demographics - For Grant Purposes
Please include the following information for the 8th-grade cohort.:
Percentage of Free/Reduced Lunch
Your answer
Number of Males
Your answer
Number of Females
Your answer
Number of Caucasian
Your answer
Number of African-American
Your answer
Number of Hispanic
Your answer
Number of Asian
Your answer
Number of Other
Your answer
Contact Information
Principal Name *
Your answer
Principal Email Address *
Your answer
Counselor Name *
Your answer
Counselor Email Address *
Your answer
Teacher 1 Name *
Your answer
Teacher 1 Email Address *
Your answer
Teacher 2 Name
Your answer
Teacher 2 Email Address
Your answer
Teacher 3 Name
Your answer
Teacher 3 Email Address
Your answer
Teacher 4 Name
Your answer
Teacher 4 Email Address
Your answer
Teacher 5 Name
Your answer
Teacher 5 Email Address
Your answer
Teacher 6 Name
Your answer
Teacher 6 Email Address
Your answer
Teacher 7 Name
Your answer
Teacher 7 Email Address
Your answer
Teacher 8 Name
Your answer
Teacher 8 Email Address
Your answer
Teacher 9 Name
Your answer
Teacher 9 Email Address
Your answer
Teacher 10 Name
Your answer
Teacher 10 Email Address
Your answer
If you have any other teachers that need to be added to this list, please email the information to "schools@southeastwow.org"
Are there any employers in your area you would like to be involved in Southeast WOW?
Company Name #1
Your answer
Contact Person (If known) #1
Your answer
Contact Information (if known) #1
Your answer
Company Name #2
Your answer
Contact Person (If known) #2
Your answer
Contact Information (if known) #2
Your answer
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