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Home
Regions
Northwest
Northeast
Central
Tampa Bay
South
Gallery
Get Involved
Scholarships
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Contact
Central Florida
School Registration Form
School County
(Required)
Please Select County
Brevard
Flagler
Lake
Marion
Orange
Osceola
Seminole
Sumter
Volusia
School Name
(Required)
Name of Person Completing This Form
(Required)
First
Last
Job Title
(Required)
Phone Number
(Required)
Email
(Required)
School Address
(Required)
Street Address
City
ZIP / Postal Code
Is the School Contact person the same as the person completing this form
(Required)
Yes
No
School Contact Name
(Required)
First
Last
Job Title
(Required)
School Contact Cell Phone Number
(Required)
School Contact Work Number
(Required)
School Email Address
(Required)
Preferred Date
Thursday, February 4th
Friday, February 5th
Number of Students Anticipated To Attend
(Required)
Number of Teachers/Chaperones Attending
(Required)
How many teachers will be bringing students with these groups?
0
1
2
3
4
5
#1 Teacher Name
(Required)
First
Last
Teacher Phone (Day of Event)
(Required)
Teacher Email
(Required)
#2 Teacher Name
(Required)
First
Last
Teacher Phone (Day of Event)
(Required)
Teacher Email
(Required)
#3 Teacher Name
(Required)
First
Last
Teacher Phone (Day of Event)
(Required)
Teacher Email
(Required)
#4 Teacher Name
(Required)
First
Last
Teacher Phone (Day of Event)
(Required)
Teacher Email
(Required)
#5 Teacher Name
(Required)
First
Last
Teacher Phone (Day of Event)
(Required)
Teacher Email
(Required)
Are the students attending from a CTE program?
YES
NO
What discipline are your students learning?
HVAC
Plumbing
Electrical
Engineering
Construction
Other
Would you like your students to see these types of learning labs or explore other disciplines?
See related labs
Explore other disciplines
If you are able to provide your own transportation, please select YES. If not, please select NO
(Required)
Transportation costs will be reimbursed
YES
NO
Bus Pick-Up Location
(Required)
Street Address
City
Are bus pick-up and drop-off locations the same?
(Required)
Yes
No
Bus Drop-Off Location
(Required)
Please note: the Venue Location for CCD has been changed to the Volusia County Fairgrounds
Street Address
City
Bus holds 53 Passengers (Students/Chaperones/Teachers). Do you require special accommodations?
Yes
No
School Start Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
School End Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Bus Pickup Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Bus Dropoff Time
(Required)
Hours
:
Minutes
AM
PM
AM/PM
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Donations
USD
Please Select Donation Amount
Platinum $1500.00
Gold $1000.00
Silver $500.00
Bronze $250.00
Other Amount
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