Creating and Leading a Differentiated Classroom

My participation in this course is:

Confirmed. I have received approval from my school.
Provisional. I have yet to receive approval from my school. If I do not get approval I will withdraw my application.
Confirmed. I am funding this myself.

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Name

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School

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Position

Kindly specify the grade/year level/subject you are teaching if you are a teacher.

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Besides the email you've specified above, how can we communicate with you?

Kindly specify one option. This is a backup option that will be used if we cannot get through to you via email.

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Contact number/ID for the option you have chosen above.

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What are you expecting to gain from this workshop?

Not a required question but an important one as your input will help the trainer understand your needs.

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If your school is sponsoring this PD...

We will coordinate the payment with the staff responsible at your school. Kindly provide us with the information requested below.

Name of Coordinating Staff

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Coordinating Staff's Email

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Coordinating Staff's Phone

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Terms and Conditions

If you have registered for a workshop and cannot attend... Replacement You can arrange for somebody to replace you . Please let us know at least two weeks in advance if possible so we can prepare name tags and certificates accordingly. Refund 85% of the workshop fee will be refunded if cancelation is made by 21 days prior to the workshop date. (15% deducted to cover application processing and bank charges) We will not be able to offer refund for late cancelations (less than 21 days before the workshop). Workshop Re-scheduling/ Canceling Knowledge Source Institute reserves the right to reschedule or cancel the workshop due to unforeseen circumstances. In instances where we have to reschedule/cancel we will refund the entire workshop fee only.

I agree to the Terms and Conditions outlined above

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