| Diocese of Jefferson City

Name of School(Required)

Administrator Name(Required)

Administrator Email(Required)

LUNCH INFORMATION:

Lunch is being provided by Firehouse Subs. There will be a variety of sub boxes which includes an 8" sub sandwich, chips, pickle and cookie -OR- chopped salads.

Total number of administrators, teachers, staff attending:(Required)

Are there any dietary restrictions?(Required)

Please list dietary restrictions:(Required)

DIOCESAN IN-SERVICE GROUP FACILITATOR VOLUNTEER

Do you have a teacher willing to volunteer as a Group Facilitator?(Required)

Name of Teacher Volunteer(Required)

Volunteer Email Address(Required)

Indicate Grade/Subject Level Volunteer is Comfortable Facilitating:

If "OTHER" was chosen, please specify subject below:

SCHOOL - DIOCESAN IN-SERVICE REGISTRATIONS

LUNCH INFORMATION:

DIOCESAN IN-SERVICE GROUP FACILITATOR VOLUNTEER

Indicate Grade/Subject Level Volunteer is Comfortable Facilitating:

DIOCESAN OFFICES and PROGRAMS