5N581 Hidden Springs Dr St. Charles IL 60175 630-377-5035 eknowlton@adventures-in-education.com
Registration Form
2011/2012
Email Registration: Click on eknowlton@adventures-in-education.com and Copy and Paste the content of the Registration Form into the email template. Complete the requested information and send (If you are unable to type the requested information into the registration form, print the form, insert information by hand, scan document, save as word or PDF, and email the completed registration form as an attachment to: eknowlton@adventures-in-education.com ).
Complete all parts to register for the course(s) you wish to enroll.
Part 1: Student Information
Date: _____________
Term: Winter __ Spring __ Summer __ Fall __
Last Name: _______________________ First Name: _________________________
Street Address: ________________________________________________________
City: ____________________________ State: ____________ Zip Code: _________
Phone: (home) _____________________ (school) ______________________________
Email: (home) _____________________ (school) ______________________________
Part 2: Graduate Credit Information for PSU Registration
Social Security Number: _____________ PSU ID (optional): _____________________
Gender: Male __ Female __
Date of Birth: Month/Day/Year __________
Employer: __________________________________________________________________
Street Address: ____________________City: _____________State: __ Zip Code: _______
What subject(s) do you teach? _____________________________________
What grade level do you teach? _______________
How did you hear about us?
Email __ Flyer __ Website __ District __ Referral __ PSU ___
Do you have a bachelor's degree? Yes __ No __
Do you consider yourself an Oregon resident? Yes __ No __
For how long have you been an Oregon resident? ________
Are you a US citizen? _____ If not, provide information: ________________________
Is this your first PSU registration? ______
Part 3: Course Selection
Please mark the course(s) you are registering for.
Special Fee: Special Fee, if applicable, indicates a Textbook is required for the course. The $40 fee includes the textbook, USPS priority mailing, and handling.
Note:
The TI-83/84 textbook is the same for all courses that use the TI-83+/84+ graphing calculator and you only need to purchase one textbook if you sign up for multiple TI-83/84 courses.
The EXCEL textbook is the same for both EXCEL courses and you only need to purchase one textbook if you sign up for both these courses.
If you have previously taken a TI or EXCEL course with Adventures In Education and purchased the corresponding textbook, you do NOT need to order another textbook unless you wish to have another copy.
___ Math 5100: Teaching Mathematics through Multiple Intelligences (2 Quarter Credits)
Tuition: $335; Grad Credit Fee: $110; Special Fee: NONE—free Online Course Workbook
___ Math 5104: Explore Math Connections! A Curriculum for all Students of the Millennium (2 Quarter Credits)
Tuition: $335; Grad Credit Fee: $110; Special Fee: NONE—free Online Course Workbook
___ Math 5110: Creative Math! A Hands-on Approach to Teaching Math Through the Standards (2 Quarter Credits)
Tuition: $335; Grad Credit Fee: $110; Special Fee: NONE—free Online Course Workbook
___ Math 5120: Teaching Quantitative Literacy Through the Standards (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: $40 (Quantitative Literacy textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Math 5131: Multiple Intelligences and Brain-Compatible Learning in the Math Classroom (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: NONE—free Online Course Workbook
___ Math 5138: Teaching Statistics with Excel, Part I (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: $40 (EXCEL textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Math 5139: Teaching Statistics with Excel, Part II (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: $40 (EXCEL textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Math 5140: How To Best Use Your TI-83+/84+ Calculator (2 Quarter Credits)
Tuition: $335; Grad Credit Fee: $110; Special Fee: $40 (TI-83/84 textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Math 5141: Making Statistics Come Alive with the TI-83+/84+ Calculator Part I (2 Quarter Credits)
Tuition: $335; Grad Credit Fee: $110; Special Fee: $40 (TI-83/84 textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Math 5142:Making Statistics Come Alive with the TI-83+/84+ Calculator Part II (2 Quarter Credits)
Tuition: $335; Grad Credit Fee: $110; Special Fee: $40 (TI-83/84 textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Math 5144: Using the TI-83+/84+ Graphing Calculator to Teach Algebra I (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: $40 (TI-83/84 textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Math 5145: Teaching Algebra II Using the TI-83+/84+ Graphing Calculator (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: $40 (TI-83/84 textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Math 5147: Basic Trigonometry with the TI-83+/84+ Graphing Calculator (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: $40 (TI-83/84 textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Math 5150: College Algebra with the TI-83+/84+ Graphing Calculator (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: $40 (TI-83/84 textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Math 5152: Pre-Calculus with the TI-83+/84+ Graphing Calculator, Part I (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: $40 (TI-83/84 textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Math 5153: Pre-Calculus with the TI-83+/84+ Graphing Calculator, Part II (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: $40 (TI-83/84 textbook: includes USPS priority mailing, and handling)—free Online Course Workbook
___ Sci/Math 5160: Environmental Studies with Math Applications (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: NONE—free Online Course Workbook
___ INST 5201: Online Pedagogy: Teaching and Designing Effective Online Courses (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: NONE
___ INST 4202/5202: Prepare Your Students for the Math College Placement Test (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: NONE
4202--Undergraduate Level; 5202--Graduate Level
___ SCI 5210: Science and Math through the Standards; Level: HS & Col (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: NONE—free Online Course Workbook
___ SCI 5231: Science and Math through Multiple Intelligences and Brain-Based Learning; Level: All (3 Quarter Credits)
Tuition: $410; Grad Credit Fee: $165; Special Fee: NONE—free Online Course Workbook
Part 4: Payment
Method of Payment:
1. Credit Card:
Charge the following amount to my credit card: _______
___ Visa ___ MasterCard
Acct# _______-_______-_______-_______ Exp. Date ____/____
Print Name as it appears on Credit Card: ___________________________________
OR
2. PURCHASE ORDERS: We accept Purchase Orders (PO) and District Vouchers for payment. In order to process your registration with a PO or Voucher:
We will promptly process your registration upon receipt of REGISTRATION FORM.
You will receive a registration confirmation via email providing information on how to get started and course details.
THANK YOU and ENJOY THE COURSE(S)!!