Online Convention Registration First Name Last Name Street City State Zip Home Phone Office Phone Your Email Which best describes you? StudentTeacherOther University or School District Email Address for your school principal/administrator Is this your first WHPE convention? YesNo Are you a lead presenter at this conference? YesNo To what district do you belong? CNENWSESW For current teachers only. Are you interested in mentoring an undergraduate student? YesNo If you answered "Yes", in what content areas would you like to mentor students (check all that apply)? PEHealthAPEDanceAdventure EducationOutdoor PursuitsTechnologyOther If you selected "other", please indicate the area in which you would like to provide mentorship. For current undergraduate students only. Are you interested in being mentored? YesNo If you answered "Yes", in what content areas would you like to receive mentorship (check all that apply)? PEHealthAPEDanceAdventure EducationOutdoor PursuitsTechnologyOther If you selected "other", please indicate the area in which you would like to receive mentorship. I am interested in a student leadership position (required) YesNoI am not a student
