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Registration
Form All fields
are required |
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Registrant Information |
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First Name: |
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Last Name: |
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Alternate First Name to
Appear on Nametag: |
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Email:
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(ex: you@there.com) Note: You must submit an email address
that we can reach you during
the school year and in the summer
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Home Address: |
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City: |
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State: |
(ex: OH) |
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Postal Code: |
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Home Phone: |
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Work Phone: |
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Employer: |
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Subject Taught: |
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Number of Years Teaching: |
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Consortium:
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Note: For
assistance in locating your consortia,
use this map
(link will open in a new window). |
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Is this
program converting from CTE to Tech Prep? |
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Yes
No
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Checklist for taking an on-line course |
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We want to make sure that you are clear on what participation in these
Academy courses requires. Please complete this short survey before
registering. If you have questions, close out the registration and read
information about the Academy on the left hand menu of the Academy Homepage |
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1. |
I understand that each unit of the
Academy involves one full day meeting and 3 weeks (Course 1); 4 weeks
(Course 2) of on-line
instruction |
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I understand that to
receive full CEU credit and certificate I must complete the on-line
course requirements of weekly discussion board participation and end of
course project |
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I
understand that I can take Course 1 and NOT take Course 2 |
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4. |
I understand that I can
take Course 2 without taking Course 1 |
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5. |
Please check each of the following computer tasks you are comfortable
executing |
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Downloading documents |
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Saving
Word documents |
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Viewing
Streaming videos |
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Viewing
PowerPoint presentations |
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(If you
are not comfortable with these computer functions, please get help from your schools’ technology staff prior to attending) |
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6. |
Have you ever taken an
on-line course |
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Yes
Number of courses:
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No
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(You do NOT need on-line
course experience to take this course. Instruction will be provided on
the launch day!) |
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| Make Your
Course Selections |
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Course One: Designing and Managing a Quality
Tech Prep Program ($75) |
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Section
1: June 17- July 8
Launch: June 17 (one day intro meeting)
Medina County Career Center, Medina Oh 44256
9:30 am- 3:30 pm
OR
Section
2: June 23-July 14
Launch: June 23 (one day intro meeting)
Tolles Technical Center, Plain City Oh 43064
9:30 am- 3:30 pm
(Additional sites will be added if enrollment warrants) |
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Course Two: All Students
CAN Succeed ($75) |
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Section 1: August 4-September 1
Launch: August 4 (one day intro meeting)
North Central College, Kehoe Center
Shelby Oh 44875
9:30 am- 3:30 pm
(Additional sites will be added if enrollment warrants) |
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Payment/Billing Information |
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The
fee for each unit is $75. This includes the one day meeting, teacher
supported on-line course, and access to the on-line course for one
academic year |
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Select One: |
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Payment
by Registrant (sending personal check) |
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Payment
by Tech Prep Consortium |
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Payment
by Employer |
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Billing Contact
Information (If Employer Paying): |
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First Name: |
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Last Name: |
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Email:
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Title: |
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Organization: |
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Address: |
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City: |
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State: |
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Postal Code: |
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Phone Number:
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Upon completion of the
on-line registration, an email confirmation and invoice (PDF document)
will be sent to you. If your Tech Prep Consortia or employer is
indicated as responsible for payment, they will also receive an email
confirmation of your registration and an invoice (PDF document) with
instructions for payment. Please follow-up to ensure payment in a timely
manner.
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