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Name

First Name

Last Name

School Name

District

Phone

(###)

###

####

Program Interest

If you do not see a workshop you are interested in, simply enter “Other” in the Workshop Name in the dropdown.

Date/time that we can discuss the work to meet your specific school/district needs.

YYYY

Time

Hour

Minute

Second

How did you hear about us?

Any other notes you would like to add:

Custom On-site Workshops Please provide the title of workshop, along with completing the required information, including a brief description of the customized workshop you would like to offer and we will contact you for additional discussion and detail. 

Let’s work together

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Seaside Educational Consultants