Jefferson County Region/MSTA Retiree Biography Request
Please fill in and submit no later than Friday, March 6th, 2020. Later on, you will receive a confirmation email with information about the JCR Regional Meeting scheduled for April 7th, 2020 at the Carriage House at Fox Run near Eureka. You will be allowed to bring one guest at no charge. Additional guests are $13 each and must be paid to the Jefferson County Region that evening. You must be a member of MSTA and be in attendance at the dinner on April 7th to receive your bell.
Name as you want it engraved on your bell *
Your answer
Home address *
Your answer
Home city, state, zip *
Your answer
Preferred phone number *
Your answer
School district *
School building *
Your answer
Preferred email address *
Your answer
Written biography. Maximum 200 words please. *
Please use third person (name, him, his, her, hers, etc.) Your biography will appear in your written form in the banquet program. There will be no editing of grammar or spelling.
Your answer
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