HD Intent to Participate Form

Office of Larry E. Reider
Kern County Superintendent of Schools
Advocates for Children
Kern County History Day 2009
INTENT TO PARTICIPATE
This form must be submitted by all schools planning to participate in History Day. Please be sure that all contact information is complete and accurate. Updated information will be sent throughout the year.
School: ___________________________ Address: ______________________________Zip__________ Phone: _________________ Fax: __________________
School Liaison Name: ______________________________________________________ Title: __________________________ Home Phone: ________________________ E-Mail:_________________________
This person is the primary liaison between the Kern County History Day Coordinator and your school. This person will receive and distribute all communication, submit the school registration packet and attend all required meetings.


Teachers: List the names of all teachers at your school whose students are participating in History Day.
Name: _______________________________ Home Phone: _________________________ E-Mail: _______________________________
Name: _______________________________ Home Phone: _________________________ E-Mail: _______________________________
Name: _______________________________ Home Phone: _________________________ E-Mail: _______________________________
Name: _______________________________ Home Phone: __________________________ E-Mail: _______________________________ Name:_______________________________ Home Phone: __________________________ E-Mail:_______________________________

Return this form by fax or mail no later than Thursday, October 2, 2008.

 Mail to: Office of Larry E. Reider
Kern County Superintendent of Schools
1300 17th Street - CITY CENTRE
Bakersfield, CA 93301-4533
ATTN: Sarah Ramsay
Hand Deliver to:
Sarah Ramsay
University Square Building, 5th Floor
2000 K Street
Bakersfield
Fax to:
(661) 636-4135

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