Michigan PPAA School — Colombiere Center — Clarkston , Michigan
May 4-10, 2008
NAME: ________________________________________
ADDRESS: _____________________________________
CITY : ___________STATE/PROV.: _______ ZIP/PC:____

            EMERGENCY
PHONE: (    )                           CONTACT: ____________

_______________________________________________

6 DAYS: ____ 3 DAYS: ____ DAY STUDENT: _____
OVERNIGHT: _________ SINGLE: _____ DOUBLE: ____
IF DOUBLE, ROOM WITH: _______________________

Interested in air conditioned single room: ________________

LIST IN ORDER OF TEACHER PREFERENCES
(FILL ALL SPACES FOR THE SESSIONS YOU WANT TO ATTEND)
Session one (May 5-7):
1. _____________________________________________
2. _____________________________________________
3. _____________________________________________
Session two (May 8-10):
1. _____________________________________________
2. _____________________________________________
3. _____________________________________________

Please Print and Mail to:
Emilie Wiley, 10348 Rene, Clio, MI 48420
Questions:
(810) 687-0519 emi1iewi1eyppaa@comcast.net
Make Checks payable to: MI PPAA