National History Day–California NATIONAL HISTORY DAY 2014–15 County Participation Form CONTRA COSTA COUNTY County: _______________________________________ ✔ Yes, our county will participate in NHD-CA for the 2014–15 School Year. No, our county will not participate in NHD-CA for the 2014–15 School Year. Reason: _______ ___________________________________________________________________________ Contra Costa County Office of Education Agency Hosting NHD in Your County: ________________________________________________ Address: _________________________________________________________________________ 77 Santa Barbara Road, Pleasant Hill, California 94523 (925) 719-7507 Sia Sauer and Brenda Stutzman Coordinator Name:_________________________________ Phone: __________________________ [email protected] Coordinator e-mail: _________________________________________________________________ http://contracostahistory.wix.com/cccnhd County HD Website: ________________________________________________________________ February 21, 2015 Date of County Competition __________________________________________________________ February 22, 2015 Weebly Lock Out Date: February ________________________ Unlock Date: ___________________________ 15, 2015 Our county will host a county level NHD competition during the 2014–15 school year. We will advance our champion students to the 2015 NHD-CA competition (May 8-9, 2015 in Rocklin, CA). I understand that our county will be responsible for payment based on the number of schools from our county registered for NHD-CA according to the fee structure below. $75 per school registered for NHD-CA (Maximum of $750) I understand that our agency will be billed after NHD-CA registration closes on March 27, 2015. Payment is due May 1, 2015. I understand that if payment is not received, my county will not be eligible to participate. Checks and purchase orders are to be made payable to Sacramento COE, Attention: Fiscal Services, PO Box 269003, Sacramento, CA 95826. Fiscal Agent: _____________________________________________________ Date: ___________ Printed Name and Signature Title of Fiscal Agent _________________________________________________________________ As county coordinator, I will be responsible for distributing and coordinating NHD-CA information to participating schools, teachers, and or parents/students within my county and I will serve as the initial point of contact for any questions related to NHD-CA. I agree to host our county competition in line with the NHD-CA 2014–15 Rulebook. County Coordinator ____________________________________________________ Printed Name and Signature Please return this form by Friday, December 19, 2014