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2008-2009 Summit and Educator Course Registration

Please complete all information below. (*) denotes a required field.

To register for more than one Summit, you must fill out a new copy of this form for each course.

(*) First Name:

(*) Last Name:

(*) Sex: M F

Home Mailing Address:
(*) Street Address:
(*) City:
(*) State: (*) Zip:

(*) Personal Cell or Home Phone (cell is preferred):

(*) Personal, Year-Round E-mail Address: (Important: we will send all correspondence to this address. Please double-check spelling and enter ONE address only!)

(*) Please re-enter Email Address for verification:

(*) School Name (if your school is not listed, select "NOT ON LIST"):

    NEW SCHOOL INFORMATION:
    (only needed if your school is NOT on the above list)

    New School Name:

    School Mailing Address:

    School City, State, Zip:

    School Phone:

(*) Your Position/Title:

(*) Grade Level(s):

(*) Content Area(s):

(*) Summits (choose ONE)

Physiology and Fitness Summit Estes Park, CO July 6-10, 2009 2 credits
Civil Rights Summit Little Rock, AR July 13-17, 2009 2 credits

University Graduate Credit Option

UC Denver Banner

Graduate credit for off site professional development courses offered by Expeditionary Learning Schools is available through the University of Colorado at Denver and Health Sciences Center for a tuition charge of $60.00 per semester credit hour, payable directly to the university. Three-day institutes earn 1.5 semester hour, five-day institutes earn 2 semester hours, and the seven-day offerings earn 3 semester hours. Participants selecting the graduate credit option will complete a project showing how strategies presented in the course will be implemented in their classrooms or their school. Participant project work is graded on a pass-fail basis, and transcripts are available upon request from the university at the end of the term in which the institute is graded. Credit will not apply toward a degree program. Participants who wish to earn university credit for an institute must indicate their intention to register by clicking below.

Click here to indicate your intention to register for credit. A registration packet will be emailed to you within two business days. If you do not receive the packet within this time frame, call 303-556-6030.

Housing

Please indicate any food allergies:

Please note any special needs we should be aware of:

Roommate Request:

(Note: For most courses, single rooms are not available. When single rooms are available we provide them for everyone on the course. We arrange double occupancy rooms for all other events.)

Fees / MOU Slots

(*) Select one:
My registration is covered by ELS contract (regular MOU slot).
I am a school principal, registering for one of our Principal Slots.
My registration is not covered by ELS contract: I will send the full payment upon acceptance of my application.

(*) Yes, I understand that in the event I need to cancel, I must fax or e-mail my cancellation at least three weeks prior to the start of the course. (FAX to 563-552-5825, e-mail to PD@elschools.org). The school will be billed for $250 for any no-shows or cancellations within 3 weeks of the start of the institute unless ELS can fill the slot.