Fillable Group Registration Illinois Cc Assessment Fair 2016 1

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Group Registration Illinois Cc Assessment Fair 2016 1

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Friday, February 26, 2016
Please use this form to register with a check payment and/or submit registration for multiple attendees
Total ($100/attendee):
1 Name to appear on badge: For our student registration system
Title: Home Address:
Email Address:
Dietary Restrictions:
**Track Interest (1, 2, 3, 4, 5): Date of Birth:
2 Name to appear on badge: For our student registration system
Title: Home Address:
Email Address:
Dietary Restrictions:
**Track Interest (1, 2, 3, 4, 5): Date of Birth:
3 Name to appear on badge: For our student registration system
Title: Home Address:
Email Address:
Dietary Restrictions:
**Track Interest (1, 2, 3, 4, 5): Date of Birth:
1 4
2
5
3
Administrative and Student Services Assessment
Assessment and Accreditation
Faculty Development in Assessment
General Education Assessment
Assessment Best Practices
School Name:
School Address:
Name of person submitting this form:
Phone Number and Email Address of person submitting this form:
Group Total Count:
Cancelations and substitutions must be made in writing and submitted by email to segan@harpercollege.edu by Friday, February 19, 2016 to receive a refund. No
refunds will be granted after February 26, 2016. No-shows are not eligible for a refund. Refunds will be issued within 30 days.
E-mail a copy of this form to segan@harpercollege.edu,
and
mail a copy with check payable to:
Harper College, 1200 W. Algonquin Road, Palatine, IL 60067, Attn: Sue Egan INST OUTCOMES
Please choose 1-3 tracks which most interest you. This information is for planning purposes only; you are welcome to attend any sessions you choose.
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Group Registration Illinois Cc Assessment Fair 2016 1

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Completed 17 April 2020

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