Lewis & Clark Region Troops To Teachers

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Name:	Last First MI
Address:
City, State, Zip:	City State Zip code
Phone:	Home Work Cell
Email:
Date of Separation / Retirement:	Date Separation Retirement
Years of service:
Degree(s) Earned or in progress / Major (s):
List, in order of preference, the THREE STATES in which you are interested in teaching:	1st preference 2nd preference 3rd preference
List the subjects and grade levels you wish to teach:	1st subject/grade 2nd subject/grade 3rd subject/grade
Additional comments/information:

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Updated: Friday, July 1, 2011 14:44