Envirothon Registration Contact Information Advisor Name Email Phone (include area code) School Name School District School Address School City School State - Select School State -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming County No Oregon CountyBaker CountyBenton CountyClackamas CountyClatsop CountyColumbia CountyCoos CountyCrook CountyCurry CountyDeschutes CountyDouglas CountyGilliam CountyGrant CountyHarney CountyHood River CountyJackson CountyJefferson CountyJosephine CountyKlamath CountyLake CountyLane CountyLincoln CountyLinn CountyMalheur CountyMarion CountyMorrow CountyMultnomah CountyPolk CountySherman CountyTillamook CountyUmatilla CountyUnion CountyWallowa CountyWasco CountyWashington CountyWheeler CountyYamhill County Zipcode Team 1 Team 1: Group Name Are you competing as an FFA Team for Natural Resources CDE? Yes No Are you registering as an FNRL team? Yes No Team 1 Member 1 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 1 Member 2 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 1 Member 3 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 1 Member 4 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 1 Member 5 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 1 Alternate Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Advisor Advisor Name T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Team 2: Group Name Are you competing as an FFA Team for Natural Resources CDE? Yes No Are you registering as an FNRL team? Yes No Team 2 Member 1 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Member 2 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Member 3 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Member 4 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Member 5 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Alternate Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Second Advisor/Chaperone Second Advisor/Chaperone Name Second Advisor/Chaperone T-Shirt Size - Select Second Advisor/Chaperone T-Shirt Size -SMLXLXXLXXXL Dietary restrictions Dietary restrictions for team/advisor(s) Yes No If yes, please describe (We will do our best to accommodate) Special Requests Any special requests for diversity, learning impaired or access assistance? (example- wheelchair, ESL, etc) Yes No If yes, please describe Registration We will submit a $100.00 registration fee (payable to Oregon Envirothon) by the date of the competition. A school PO# is acceptable. The $100.00 nonrefundable fee goes to assist with the costs of the national program. Please send to Oregon Envirothon, PO Box 892 Newberg, OR 97132 Yes We will bring the consent forms for our students on the day of the competition. Yes ReimbursementsReimbursement for overnight accommodations are available for teams traveling further than 50 miles each way.Advisors will need to make overnight accommodations for their team. OFRI can reimburse the district for a maximum of 6 rooms per team at the state rate of $98 + tax per room. Substitute Reimbursement Do you need substitute reimbursement? Yes No If you select yes, you are approved for up to a maximum of $400 per day. Bus Reimbursement Do you need bus reimbursement? Yes No School districts will not be reimbursed over approved amount for substitute or transportation reimbursement. If yes, amount requested Previous Participation Has your school ever participated in Envirothon before? Yes No
Contact Information Advisor Name Email Phone (include area code) School Name School District School Address School City School State - Select School State -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming County No Oregon CountyBaker CountyBenton CountyClackamas CountyClatsop CountyColumbia CountyCoos CountyCrook CountyCurry CountyDeschutes CountyDouglas CountyGilliam CountyGrant CountyHarney CountyHood River CountyJackson CountyJefferson CountyJosephine CountyKlamath CountyLake CountyLane CountyLincoln CountyLinn CountyMalheur CountyMarion CountyMorrow CountyMultnomah CountyPolk CountySherman CountyTillamook CountyUmatilla CountyUnion CountyWallowa CountyWasco CountyWashington CountyWheeler CountyYamhill County Zipcode Team 1 Team 1: Group Name Are you competing as an FFA Team for Natural Resources CDE? Yes No Are you registering as an FNRL team? Yes No Team 1 Member 1 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 1 Member 2 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 1 Member 3 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 1 Member 4 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 1 Member 5 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 1 Alternate Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Advisor Advisor Name T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Team 2: Group Name Are you competing as an FFA Team for Natural Resources CDE? Yes No Are you registering as an FNRL team? Yes No Team 2 Member 1 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Member 2 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Member 3 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Member 4 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Member 5 Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Team 2 Alternate Name Grade - Select Grade -9101112 T-Shirt Size - Select T-Shirt Size -SMLXLXXLXXXL Second Advisor/Chaperone Second Advisor/Chaperone Name Second Advisor/Chaperone T-Shirt Size - Select Second Advisor/Chaperone T-Shirt Size -SMLXLXXLXXXL Dietary restrictions Dietary restrictions for team/advisor(s) Yes No If yes, please describe (We will do our best to accommodate) Special Requests Any special requests for diversity, learning impaired or access assistance? (example- wheelchair, ESL, etc) Yes No If yes, please describe Registration We will submit a $100.00 registration fee (payable to Oregon Envirothon) by the date of the competition. A school PO# is acceptable. The $100.00 nonrefundable fee goes to assist with the costs of the national program. Please send to Oregon Envirothon, PO Box 892 Newberg, OR 97132 Yes We will bring the consent forms for our students on the day of the competition. Yes ReimbursementsReimbursement for overnight accommodations are available for teams traveling further than 50 miles each way.Advisors will need to make overnight accommodations for their team. OFRI can reimburse the district for a maximum of 6 rooms per team at the state rate of $98 + tax per room. Substitute Reimbursement Do you need substitute reimbursement? Yes No If you select yes, you are approved for up to a maximum of $400 per day. Bus Reimbursement Do you need bus reimbursement? Yes No School districts will not be reimbursed over approved amount for substitute or transportation reimbursement. If yes, amount requested Previous Participation Has your school ever participated in Envirothon before? Yes No
