Group Student Workshop Registration

SADDLE UP With BPIRF

Ridin' To The Top With STEM
BPIRF - U.S. Department of Agriculture

Natural Resources Conservation Service Collaboration

Student Workshop Registration Form
Organization Name
Type of Workshop
Number of Attendees
Primary Contact
Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
City & State
Referred by
You understand that by participating in the BPIRF Workshop, you will be photographed and filmed. These will be used for promotional, marketing, and educational purposes in our publications, website, or social media platforms.
Does your organization provide any STEM Programs?
If yes describe below
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Adult Chaperone - Allow up to 1 per 8 Students
Name

First NameLast Name
Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Name

First NameLast Name
Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Name

First NameLast Name
Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Name

First NameLast Name
Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
Name

First NameLast Name
Cell Number
Please enter a valid phone number.Format: (000) 000-0000.
USDA is an equal-opportunity provider, employer, and lender

BPIRF is an equal opportunity employer in accordance with all federal, state, and local equal opportunity and non-profit.
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SADDLE UP With BPIRF

Adult Chaperone - Allow up to 1 per 8 Students