Summit Registration

2014 Oregon Green Schools Summit

Friday, April 11th, 8:30 am to 2:00 pm (NOTE later end time)

NOTE NEW VENUE:  Life Community Church, 4900 NW Hwy 99, Corvallis, OR 97330

Sponsorship is cost of substitute and/or mileage. Please be sure to have exact cost of staff and mileage, and the place to mail the sponsorship check to, before you register, if you want to request sponsorship.

Attendees:  One adult and four students from each school is the maximum we can accommodate.

 

Friday, April 1, 8:30 am to 2:15 pm

Western Mennonite School, 9045 Wallace Road Northwest, Salem, OR 97304

Sponsorship covers the cost of one substitute teacher and mileage to attend the summit.

Before you register, confirm substitute reimbursement cost with your school district and be ready to provide the exact cost of the substitute, the name of the entity the substitute check should be made out to and mailing address where the check should be sent.

Round-trip mileage can be calculated using the 2016 federal reimbursement rate of 57.5 cents/mile and your travel to 9045 Wallace Rd NW, Salem, OR 97304. Please indicate the name of the person or entity the mileage check should be made out to and mailing address.

Attendees: One adult and 4 students from each school is the maximum we can accommodate.

School Name*:

Contact Person*:

Mailing Address Line 1*:

Mailing Address Line 2:

City*:

Zip Code*:

Email*:

Phone*:

Are you a registered Green School?*: Yes No 

Regional OGSA coordinator name:

Grade level(s)of students attending*
(click all that apply-
Ctl-click for multiple levels):

Name of adult attending (First/Last)*:

All groups will have the opportunity to attend the “School Spotlight” session, where students will meet in small groups to share their green team projects.

Throughout the day groups will attend three additional sessions related to the Oregon Green Schools application areas of focus: Water, Energy, Waste Reduction and Recycling.

Please indicate your school’s first choice from each category. We will do our best to accommodate your selection, however in some cases schools may be assigned to alternate sessions based on scheduling demands.

Water*

 Water Audit Castles Made of Sand

Energy*

 Transportation Options Solar Up

Waste Reduction and Recycling*

 Waste Audit Save the School Supplies

Does your display require electricity?*: yes no 

Name of company that collects your school garbage and recycling:

Reimbursement requests cannot be changed once submitted. Please confirm with your district about substitute cost before submitting.

Do you need substitute reimbursement?*  Yes No

If Yes, what is the one day staffing cost for adult attending?*

The substitute reimbursement check should be made out to:*

The staff reimbursement check should be mailed to the following address:*

Do you need mileage reimbursement?*  Yes No

What is the round-trip mileage cost from your school to the Summit, 9045 Wallace Road Northwest, Salem, OR 97304* (at $0.575/mile) ?

The mileage reimbursement check should be made out to:*

The mileage reimbursement check should be mailed to the following address:*

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PHOTO/VIDEO STATEMENT AND AGREEMENT We plan to take photographs and video at the Summit to be used for future projects, displays, program promotion and on our website. Members of the media may also be taking pictures and videos. You must agree to this statement to attend. Please do not send Summit delegates (students, staff or adults) who for any reason wish not to be photographed. We will not publish names of students appearing in photos used by OGSA. If you have questions or concerns about this policy, please contact mail@oregongreenschools.org
Please mark the check box to signify your agreement: "I have read and accept the Photo Statement"

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