2013 KS Constitutional Conference Application Form
Please select your program
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2013 Kansas Constitutional Conference
Salutation
Please select...
Ms.
Mrs.
Mr.
First Name
Last Name
School Name
School City
School State
School Zip Code
Personal Email address
Work Email Address
At which email address would you prefer to be contacted?
Personal
Work
Please indicate which of the following roles best describes you:
Teacher
Administrator
Curriculum Director
Social Studies Supervisor/Department Chair
Which courses do you teach?
US History
World History
AP History
Government
AP Government
AP Other
Economics
Civics
Law
Other
What year did you start teaching?
Which level do you teach the majority of the time?
Elementary School
Middle School
High School
Pre-Service
At what type of school do you teach?
Public
Private
Charter
Parochial
Home School
Other
How did you hear about this event?
Bill of Rights Institute Email
Bill of Rights Institute Website
Colleague
Administrator
Facebook
Edmodo
Education Week Magazine
Twitter
Other
If you heard about this event from a Colleague or Administrator, please provide their name
If you chose "other," please explain:
Do you have any dietary restrictions? (If your restriction is not listed, please contact events@billofrightsinstitute.org)
No Special Preferences
Kosher
Vegetarian
Food Allergy - Nuts
Food Allergy - Shellfish
Will you need hotel accommodations during the conference?
Yes - I will need overnight accommodations and understand that I may be paired with another participant of the same gender.
No - I will commute to and from the program, or will make my own arrangements.
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