Latino College Expo Chaperone Registration Form

Note: One chaperone per 10 students, please. 
Please submit all forms by November 2, 2009.

School / Organizational Information
School Name:
School Address:
School Phone:
Fax:
   
Chaperone Information
Chaperone Name:
Chaperone Job Title:
Chaperone Phone:
Chaperone E-mail: *
   
Student's Name Attending Expo: Student's Emergency Contact Number: