Registration Form for Courses in Schaumburg SD 54 Location: Rafferty Center, 524 E. Schaumburg Rd., Schaumburg, IL 60194 Time: 4:00 PM - 8:00 PM Last Name First Name (formal) Middle Initial Maiden Name Home Address City State Phone (home) Zip Code County Cell Phone Preferred Email Address District Name District Address City State School Name Zip Code County School Address City State Zip Code County Work Phone Number Preferred Mailing Address Home School/Work Grade Level(s) Current Position Administrator Bilingual Program Director Coordinator Counselor Parent Principal School Board Member School Psychologist Social Worker Speech Therapist Superintendent Teacher Assistant Teacher Other Current Program Type ESL Bilingual General Education Dual Language Other Please indicate whether or not you have had the following courses: Yes No Foundations in Language Minority Education Yes No Methods and Materials ESL Bilingual Fall 2015 Assessment of Language Minority Students CIL-510 163002650 September 23, 30, October 7, 14, 21, 28, November 4, 11, 18, 25 (clinical), December 2, 2015. Winter 2016 Reading in New Language: Linguistic Considerations CIL 512 163002680 January 6, 13, 20, 27, February 3, 10, 17, 24, March 2, 9, 16, 2016. Pay in Full $615.00 ______________ Pay in Full $615.00 ______________ Registration deadline for Assessment class is December 18, 2015. For payment by check ONLY, mail to: The Center/IRC, PO Box 408379, Chicago, IL 60640-0010 For payment by credit card, mail to: The Center/IRC, 2626 S Clearbrook Dr., Arlington Heights, IL 60005 □ Check #______ enclosed in the amount of $ (make check payable to THE CENTER) □ Charge my credit card in the amount of $ □ Visa □ Master Card Account number Cardholder Name (please print clearly) Expiration date Cardholder Email Address Cardholder billing address: City State ____Zip Code _________County Cardholder signature I have read and agree to the registration and attendance terms and policies as related to courses listed on the next page. Please Initial:_______________ CODE: 4330 40 300-16 If you have missed the deadline, you must call the IRC prior to mailing a registration form to ensure space is available. IRC Attendance Policy These Bilingual and ESL endorsement courses are graduate level courses with the expectation that students will attend all classes promptly. It is highly recommended that you make every effort to attend the first class of any course sequence as the general scope of the course/clinical dates/assignments are outlined in the syllabus distributed at this first session. In order to avoid a conflict with regard to attending the first session, please check your school calendar before registering for a specific course. (Conflicts due to national or religious holidays may be resolved with an instructor.) Should there be an issue pertaining to non-attendance at any class session, it will be the student’s responsibility to obtain any missed information. For evening classes, one absence with an acceptable excuse is permitted, but two missed classes will cause the student’s grade to be lowered one letter, and after a third absence the student must withdraw from the course. Significant lateness will accumulate as an absence as well. Should a student need to withdraw/drop a course, the request must be submitted in writing. Please note that in cases of bad weather, TV/radio/website announcements regarding National Louis University may not apply to IRC classes. Please call the IRC directly for possible class cancellations. This information will also be posted on the IRC website. Saturday class participants should contact their instructor directly. IRC Registration and Payment Policy Registration for the fall course must be accompanied by tuition payment in full for the amount of $615.00. Of this amount, $75.00 is non-refundable and cannot be applied toward any other courses in the event of cancellation by the participant. After the second session of the course, there will be NO tuition refunds. Because of limited enrollment policies, registration will be taken on a first come, first served basis. The IRC reserves the right to cancel a course due to low enrollment. CLASSES FILL QUICKLY. MAKE SURE TO REGISTER EARLY.