Registration Form (please print and mail)
Each registrant must complete a registration form and provide all the information requested below.
Forms that are incomplete or that contain more than one name will not be honored.
Print this form and send it with your payment to:
Department of Teacher, School, and Family Programs
Teacher Workshops
National Gallery of Art
2000B South Club Drive
Landover, MD 20785
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Name
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Home address
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City / State / Zip code
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Home telephone / E-mail address
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School name
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School address
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City / State / Zip code
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School telephone / School fax
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Subject taught / Grade level
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Principal or supervisor
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How did you hear about the National Gallery of Art's Teacher Workshops?
Check desired workshop(s). Repeat programs may be held if there is sufficient demand; please indicate whether you would also be available for the alternate workshop date.
Teacher Open House ($10)
[ ] Wednesday, November 5, 2008
[ ] First-time participant
[ ] Past participant registering with a first-time participant (submit both registration forms together)
A Moving Experience ($10)
[ ] Wednesday, January 21, 2009
[ ] (Repeat date: Wednesday, January 28, 2009)
Pompeii and the Roman Villa ($10)
[ ] Wednesday, February 4, 2009 (Session full - Wait list only)
[ ] (Repeat date: Wednesday, February 11, 2009) (Session full - Wait list only)
Every Picture Tells a Story ($10)
[ ] Wednesday, March 18, 2009 (Session full - Wait list only)
[ ] (Repeat date: Wednesday, March 25, 2009)
George de Forest Brush: The Indian Paintings ($20)
[ ] Saturday, December 6, 2008
[ ] (Repeat date: Saturday, December 13, 2008)
Dutch Cityscapes ($20)
[ ] Saturday, February 21, 2009 (Session full - Wait list only)
[ ] (Repeat date: Saturday, February 28, 2009)
Total amount enclosed: $__________