Kansas State Debate

High School > Wildcat Debate Workshop > Wildcat Debate Workshop Registration Form

Please fill out the following form to assist in your workshop registration. Your information will remain confidential. All information will be emailed to kstatedebate@gmail.com. Please fill it out completely or the form will return an error.

Your Name:

Your Email Address:

Housing/Food Arrangements:

commuter - free

shared housing - no food $210

shared housing - three meals a day $330

single housing - no meals $300

single housing - three meals a day $410

I am a coach with experience in :

 Policy Debate LD Debate Forensics No Forensics or Debate Experience Other

social security number: (Without it internet access can be restricted)

School Name:

Phone Number:

T-Shirt Size (Small-3xl):

Parking is a $15 charge. If you need parking, please provide, year, vehicle make/model and licence #::

Roomate Preference (if any...)::
Please explain what you would like to walk away with from this Teacher's Workshop
The areas I would like to improve as a teacher include

Address To reach you at:

City, State, Zip Code:

If yes, where?
EMERGENCY CONTACTS In the event of an emergency, please provide us with contact information.
Name #1
Relation
Work Phone
Home Phone
Cell Phone
Name #2
Relation
Work Phone
Cell Phone
HEALTH INFORMATION (OPTIONAL) INFORMATION WILL BE KEPT CONFIDENTIAL!!!
Health Insurance Company
Health Insurance Number
Allergies
Current Medications
Please provide any other medical info

Additional Comments and Questions: