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Prince William County
Public Schools Community Relations Office, P.O.Box 389, Manassas, VA 20108 RESOURCE SPEAKER REGISTRATION Date__________________ Title_____Name_______________________Phone:
Work___________Home__________ Occupation_______________________________________________________________ Mailing
Address________________________________________________Zip_________ Email____________________________________________________________________ Please indicate which
grade level(s) you would be most comfortable speaking to: ____Elementary _____Middle School _____High School ______Clubs _____All Resource speakers may
share aspects of their work, travels, hobbies, talents, special interests,
and/ or past experiences, i.e. military, ethnic or cultural. Movies, slides, souvenirs and artifacts
are appreciated; however, personal property of the speaker shall remain the
responsibility of the owner. The
Prince William County school division does not accept responsibility for the
safekeeping of or damage to private property while on school premises. Firearms and weapons of any kind are
prohibited. The property owner shall
arrange for insurance of items if necessary. Information is provided
to teachers in a data base format.
Complete contact information is required. For your information, only the Community Relations staff will
review registration forms.
1. ________________________________ 2. ________________________________ 3. ________________________________ 4. ________________________________ For database development purposes, list key words that would identify your topic: Please indicate if you would be able to present in a language other than English. _________________________________________________________________ _________________________________________________________________ Please mail
to: Community Relations Office, P.O.Box 389, Manassas, VA 20108 Or call (703) 791-8720 to register: FAX: (703) 791-8842 Email: williamb@pwcs.edu (Form Rev. 2002-03) |