Event Course Design Institute
Dates January 4-6, 2011 TEAMS ONLY:  Per team fee applies when teams of 2+ from the same institution attend the same event. $1000
Location Kirkwood Fee per person for a team with more than 2 members $400

If you have any questions, please feel free to contact:

Al Rowe  arowe@kirkwood.edu

* denotes a required field

For multiple person or group registration, enter
a contact person or group representative in the fields at left and the remaining names, one
name per line, below:
* Name:
* Dept/Discipline:
* Institution:
* Work Phone:
  Home Phone:
  Fax:
* E-mail:
   
* Select Event: Course Design Institute
 
* Payment Method: Please bill me.  Use Purchase Order number:

A Check made payable to:

Pacific Crest

is being sent to:

Pacific Crest

Attn: Coe-Kirkwood RPDC

906 Lacey Ave., Ste. 206

Lisle, IL 60532

I Am registering as a participant from the host school. My registration is being paid by my institution.
   
 
* Payment Amount:
 

Form Verification (anti-spambot measure):    Is ice hot or cold? 

Questions/Comments/Reasons for Attending:

Cancellation and Refund Policy

Registrations cancelled more than 7 days in advance of an event will receive a 100% refund.

A 75% refund is given if a cancellation is received within 1 week of the event.

A 50% refund is given if a cancellation is received within 24 hours of the event.

This penalty is charged to offset the expenses to Pacific Crest resulting from the cancellation.