Winter Workshop Registration Form

February 21, 2004
FAX, Mail, or Email registration information by February 16, 2004.

* See note below.

Full Name:  
Home Address (H or W):  
City, State:  
Phone (H or W):    email:  
SS#: 
For ACT 48 reporting only.
 
PSLA Member?  (Circle one)   YES     NO
Act 48 Credit:
The above information is needed in order to process ACT 48 credit.  A certificate will be provided at the workshop for 3 hours.
 
Send registration to:
Reed Williams
% Shady Side Academy
423 Fox Chapel Road
Pittsburgh, PA 15238
Email:
rwilliams@shadysideacademy.org
FAX:
412-968-3004
Contact Reed Williams:
412-968-3073  (W)

*

Please be advised that the PSLA Board of Directors has passed a resolution charging a $10.00 registration fee to non-PSLA members.  Please make check payable to PSLA and send with your registration.

Return to Winter Workshop
Return to WPSLA home page.

Contact Rich Hollein at holleinr@qvsd.org for more information about WPSLA.


Prepared by Linda Herward 1/22/04
Contact Linda Herward at lherward@comcast.net