APPLICATIONS PART #1 AND #2 FOR SUMMER INSTITUTE 2014

 APPLICATION / PRE-TEST FOR SUMMER INSTITUTE 2014
JUNE 9 – 13, 2014

            To ensure that your application is considered for admission to Summer Institute 2014, please make sure that you complete and submit both pages.  Seating is limited so please submit the APPLICATION and PRE-TEST as soon as possible.  Applications will be accepted through Monday, June 2nd. Graduates received 60 Recertification Credits!

Page 1 of 2:                Application 2014

Name ____________________________________________________________________________

Number of years teaching/guidance                                                                                           

Title/Position (subject, grade level etc.)_________________________________________________

School & Address__________________________________________________________________

Home Address ____________________________________________________________________

Home Phone ___________________________ School Phone ______________________________

E-mail (This is how we will notify you)______________________________________________

Have you applied to Summer Institute in the past?            YES ________      NO __________

If “YES”, which year(s) did you apply?     ____________________________________

Was your application:                               ACCEPTED                    DECLINED

****SI Participants prior to 2007 may reapply****

 What is your most pressing concern/problem related to troubled children?_____________________________________________________________________________
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