College of Education

WSU Tri-Cities Education Summit Registration

Are you a current WSU student? If so, do not register with this form; please email Chris Gana at cgana@wsu.edu to register at no cost.

First Name:

Middle Initial:

Last Name:

Email:

Phone:

Address:

Certificate Number (if you will be requesting clock hours)

What school/organization are you affiliated with?

What is your position?

How did you hear about the Education Summit?

If you chose other to either question, please specify:

Payment will be on the next page. Need help? Please call us at 509-372-7366 or email llightner@wsu.edu if you need assistance with registration.