Application Form

Personal Information:

School(s) where presently employed:

School(s) where previously employed:

What is the most rewarding part of your job and why?

What is the most frustrating part of your job and why?

What is the most important thing you hope to gain from this course?

What do you think you could contribute to this course?

Course Fee:

The cost for this course, including all source materials, is $750 USD

I (or my school) will pay the full cost

I would like to request a subsidy:

Reference:

Please label in order of your preference with 1 being the best time for the course and 3 being your last option.

If a time slot does not work at all for you please do not label it.

Mornings (10:00 or 11:00 am)

Afternoons (2:00 pm)

Evenings 8:30 pm

Comments or Questions: