Natural Resource/Conservation Program
Registration Form
Fall 2012 & Spring 2013
Teacher Name:
Grade:
School:
Address:
E-mail:
Fax:
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Please contact me to schedule a program on the following topics. Please check all programs that you would like to offer:
Grade
Topic
Preferred Month for Program Delivery to Class
1st Choice
2nd Choice
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K
Trees
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K
Butterflies
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1st
Circle of Earth
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1st
Bats
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2nd
The Incredible Edible Landfill
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2nd
Birds
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3rd
Animal Tracks
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3rd
Just a Dream
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4th
Illinois Prairie
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4th
Illinois State Symbols
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3rd, 4th, 5th
Soil
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5th
Enviroscape Model
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Please fax completed form to: 815-433-5454 or mail to: Linda Reynolds, University of Illinois Extension, 1689 N. 31 st Road, Suite 2,
Ottawa, IL 61350. Any questions, call 815-433-0707. Thank You!