Missouri Project WILD Workshop Proposal Name Address City State Work Phone Home Phone Fax Number E-mail Zip Date(s) of proposed workshop Times Location Facilitators Audience represented Estimated number of participants Number of WILD Guides needed: Items automatically sent: WILD K-12 Guide WILD Aquatic Guide Certificates WILD pencils & post-its WILD Correlations (if available) Growing Up WILD Attach Proposed Workshop Agenda Return form at least three weeks prior to workshop to: Missouri Project WILD Missouri State University, Dept of Biology 901 S National Avenue Springfield, MO 65897 Fax: 417-836-8886 E-mail: EricaCox@missouristate.edu or JaniceGreene@missouristate.edu