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Registration Form – UF Cancer Research Conference for Science Teachers 2026

"*" indicates required fields

Name*

First Last

Contact Information*

Street Address Address Line 2 City State ZIP Code

Name of county in which you live*

Phone*

Email*

Date of Birth (##/##/####)*

DOB is used for reimbursement purposes.

Name of School*

City*

County*

State*

Are you a Title 1 school?

What grade level(s) do you teach?*

What subject(s) do you teach?*

Will you require hotel accommodations for this event?*

Are you staying with another teacher? Please their include name.

Are you driving, flying, or carpooling with another teacher?*

Will you be attending the welcome event at the UF Hilton on Tues, June 16, at 6:30 PM?*

Will you be attending the social mixer at the UF Harn Museum on Wed, June 17 at 6:30 PM?*

Do you have any dietary restrictions or other special needs? Please explain.