Event Registration Form (2221 bytes) Operation Outreach Economic Education
Patricia A. Palmer, Ed.D., Field Coordinator
University of Missouri-Kansas City
Contact: Phone 660-646-5229 or E-Mail

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This registration form may be used for Graduate Courses, Workshops, Seminars, and Conferences.

Three easy ways to sign up! Choose the method that works best for you...

  1. Complete the form online and click on the Send button. Patty will contact you to confirm your registration and obtain payment information.
  2. You may also print the form and fax it to Patty at 660-646-3106 (Attention: Patty Palmer)
  3. Print and mail the form to 17848 LIV 4397, Chillicothe, MO 64601

Event:

Teacher Name:

Grade Taught:

Subject Area:

School:

District:

School Address:

School City

School State/Zip:

School Phone:

School Fax:

School E-Mail:

If you have no school email, please enter "none."

Home Address:

Home City:

Home State/Zip:

Home E-Mail:

Home Phone:

If graduate credit is optional, are you planning to enroll?

Yes  No
If the event is offered at more than one location, please indicate your choice:

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Patricia A. Palmer, Ed.D.
Field Coordinator
Chillicothe, Missouri
E-Mail: outpalmr@greenhills.net
Phone: 660-646-5229
Also visit the Missouri Council on Economic Education

Web Site updated 04/13/2004.

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