Northern District of Illinois

United States District Court
Northern District of Illinois
Honorable Virginia M. Kendall, Chief Judge | Thomas G. Bruton, Clerk of Court

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Teacher Registration Form

Complete the following required fields below to register.

Name/Organization:

School/Address:

Workshop Date:
(XX/XX/XXXX)

Please enter correct date format(MM/DD/YYYY).

Contact Phone Number:
( (XXX)-XXX-XXXX )

E-Mail Address:
(XXXX@XXXX.Com)

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