Registration Form for Courses in Chicago Location: Palmer Elem. School, 5051 Kenneth, Chicago, IL 60630 Time: 4:00 PM – 8:00 PM ❏ Mr. ❏ Ms. ❏ Mrs. Last Name __________ First Name (formal) _______ Maiden Name _________________________ Home Address City ______________ County _____________________ State _________ Zip Code _____________ Phone (home) ____Cell Phone Social Security Number (last 4 digits) ___ ____________________ Preferred Email Address _____________________________ School Name/District/Program Name School/Work Address City ______________ State _________ Zip Code _____________ County ____________________ Phone (work) Position Preferred Mailing Address: Home _________ Grade Level(s) School / Work _________ ❏ 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 Note: Attendance at the first class of each course is mandatory. A student will be dropped from the class if s/he does not attend this first session. If you have missed the deadline, you must call the IRC prior to mailing a registration form to ensure space is available. Please complete and mail registration with your check (payable to The Center) or credit card number to: The Center: Resources for Teaching and Learning/Illinois Resource Center, P.O. Box 2401, Bedford Park, IL 60499-2401 WINTER 2011 Reading in New Language: Linguistic Considerations CIL-512 114020281 Jan. 5, 12, 19, 26, Feb. 2, 9, 16, 23, Mar. 2, 9, 16, 2011 Deposit: $75.00 _________ Balance Due: $475.00 ___________ ❏ Check enclosed in the amount of $_________ (make check payable to THE CENTER) ❏ Charge my credit card in the amount of $ ❏ Visa: Account number ____ Expiration date ❏ Master Card: Account number ____ Expiration date Cardholder (please print) Cardholder signature I have read and agree to the registration and attendance terms and policies related to IRC courses as listed on the attached page of this document. Please Initial: _____ Code: 4330-40-300-11 Registration Deadline for IRC is 4 Weeks Prior to the Starting Date of This Course Based on Space Availability! If you have missed the deadline, you must call the IRC prior to mailing a registration form to ensure space is available. IRC Registration and Payment Policy Registration for courses must be accompanied by a $75 nonrefundable deposit per course. Deposits 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. The remaining tuition balance (minus deposit) must be paid no later than four weeks prior to the course starting date. If full payment has not been received four weeks prior to the start date of the course, a student will be dropped from the class roster in order to accommodate others who may be on the waiting list. 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. IRC Attendance Policy These are graduate level courses with the expectation the students will attend all classes promptly. Attendance at the first class of each course is mandatory. A student will be dropped from the class if s/he does not attend this first session. For evening classes, one absence (half-day for all-day classes) with an acceptable excuse is permitted, but two missed classes (one day for all day 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. For further information, call the Illinois Resource Center 224-366-8555 CLASSES FILL QUICKLY – REGISTER AS SOON AS POSSIBLE.