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Media Specialist Collaborative
Please complete the registration information form below. Should you need to cancel your registration, please contact Evelyn Joiner at
ejoiner@fdresa.org
.
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Email Address
*
Your answer
District
*
Appling
Bulloch
Bryan
Camden
Candler
Effingham
Evans
Glynn
Jeff-Davis
Liberty
Long
McIntosh
Savannah-Chatham
Screven
Tattnall
Toombs
Vidalia-City
Wayne
Other
Required
School
*
Your answer
Registration Cost: $20.00*
*Continental breakfast and lunch are included in the registration cost. Provide information so that FDRESA can invoice for this fee. If a PO number is available at the time of registration, please provide it in the field below.
Bill to:
*
Include the address and contact information. First District RESA ETC will invoice the individual or the school/district, whichever is applicable. Once an invoice is received payment can be mailed to: FD RESA ETC, P.O. Box 780, Brooklet, Ga. 30415.
Your answer
Purchase Order Number
(If available at the time of registration.)
Your answer
Lunch Selection
Please indicate your lunch preference. All lunches will include water or tea.
Chick-fil-a Box Lunches
*
Chick-Fil-A Sandwich, Fruit Cup, Chips, Cookie.
Veggie Wrap (Monterey Jack cheese, lettuce, tomato, spinach, carrots, cabbage), Dressing, Fruit Cup, Chips, Cookie.
Grilled Chicken Salad - tossed salad topped with grilled chicken breast
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