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Lancaster-Lebanon IU 13 Gifted Network 2015-16 District Membership Form District: Administrative Contact: Gifted Program Contact(s) Assigned Grade Level(s) Phone Number(s) Cost is $50 per participant Please bill my district $ ($50 • x Participants) Payment of $ is enclosed Administrative Signature: New for 2015-16! IU13 Gifted Network Member Electronic Directory Please include district members in directory Yes No Please fax, mail, or email the District Membership Form to Janice Estabrook, Gifted Education and Enrichment Coordinator, no later than: August 1, 2015 1020 New Holland Avenue Lancaster, Pennsylvania 17601 Phone: (717) 606-1732 Fax: (717) 606-1774 Teachers must register for individual Gifted Network Meetings online. Questions? Call Janice at (717) 606-1732 or email at [email protected] NOTE: This fee structure is dependent upon at least 15 school districts participating in the Gifted Network Program. E-Mail Address(es)