Making Math Real Course Registration Form for Printing/Mailing/Faxing
1. Please fill out registration form: * = required fields
* First Name:
__________________________________________________________________________
* Last Name:
__________________________________________________________________________
*Address:
__________________________________________________________________________
* City:
__________________________________________________________________________
* State:
__________________________________________________________________________
* Zip:
__________________________________________________________________________
*Cell Phone:
__________________________________________________________________________
* E-Mail Address:
__________________________________________________________________________
School (if teacher):
__________________________________________________________________________
School address:
__________________________________________________________________________
2. Please CHECK the COURSE(S) & INSERT the appropriate course DATES in which you wish to enroll:
___Making Math Real Overview* (2 day course) $349.00
Dates of Classes: _____________________________________________
* Overview Prerequisite: This course is the mandatory prerequisite overview that everyone must attend before enrolling in all other Making Math Real series courses. Please note that the Pre-Algebra and Algebra courses require additional prerequisites [see Course Descriptions for details].
___4 Operations & The 400 Math Facts (12 day course) $1999.00
Dates of Classes: _____________________________________________
___9 Lines Intensive (2 day course) $349.00
Dates of Classes: _____________________________________________
___Fractions, Decimals & Adv. Place Value (12 days) $1999.00
Dates of Classes: _____________________________________________
___Pre-Algebra (10 day course) $1749.00
Dates of Classes: _____________________________________________
___Algebra (10 day course ) $1749.00
Dates of Classes: _____________________________________________
___Games! (2 day course) $349.00
Dates of Classes: _____________________________________________
___Kindergarten (3 day course) $524.00
Dates of Classes: _____________________________________________
___Time & Money (2 day course) $349.00
Dates of Classes: _____________________________________________
3. Please apply any of the eligible discounts below to your “Registration Fee Total:”
*21 Day Early Bird Discount – Save 10%
(Registration must be faxed or postmarked 21 days in advance of the 1st day of class.)
**GROUP DISCOUNTS: Schools, Districts and Organizations receive the following “Group Discounts” when registering 2 or more educators in the same Making Math Real course:
Register 2 teachers in the same course & save 10% on tuition
Register 3-5 teachers in the same course & save 15% on tuition
Register 6-9 teachers in the same course & save 18% on tuition
Register 10 or more in the same course & save 20% on tuition
REGISTRATION FEE TOTAL : $ ______________________________________
4. Please check all areas that describe your background and teaching status:
Ο Classroom Teacher
Ο Administrator
Ο Ed. Therapist / Learning Specialist
Ο Special Educator (RSP / SDC)
Ο Tutor
Ο Parent
Ο Other: ________________________________________________________________
5. Make payment and sign: Full payment must be submitted with your completed registration form. Reservations will be granted on a first-payment, first-served basis. Initial registration confirmation will arrive via email within 3 business days.
1. Pay by Check or Purchase Order payable to:
Making Math Real
PO#: ___________________________________
2. Pay by Credit Card (Visa or Mastercard only):
* Credit Card Type: _____ Visa _____ MasterCard
* Credit Card #: ___________________________________________________
* Expiration Date: ____________ (mm/yy)
* Billing Zip Code: ______________________
REGISTRATION PAYMENT & REFUND POLICY – PLEASE READ CAREFULLY BEFORE SIGNING: REGISTRATION PAYMENT, WALK-INS & REFUND POLICY – PLEASE READ CAREFULLY BEFORE SUBMITTING: Course registration ends 24 hours prior to the 1st day of a class. If you miss the registration deadline do not register online. Walk-ins on the first day of class are accepted based on available space in the course (we advise you to arrive at least 15 minutes early). Course cancellations and/or transfer requests by enrolled participants must be received in writing 5 business days BEFORE each scheduled course starting date, and are subject to a $100 processing fee. Cancellations received less than 5 business days prior to a class will NOT be refunded. There are absolutely no refunds once a course has been attended. Transfer requests must be made 5 business days prior to the start of the course and are subject to a transfer processing fee. All course registrations are non-transferable once a course has been attended. Making Math Real cannot accommodate any requests to split course attendance between 2 course offerings. There are NO MAKE-UPS for missing class under any circumstances for Making Math Real courses.
MAKING MATH REAL INSTITUTE DISCLAIMER: Whereas the Making Math Real Institute makes all efforts to keep all courses open, the Making Math Real Institute reserves the right to cancel any course at any time based on low enrollment, at which time all participants previously enrolled in said course will be notified via email in advance of the course start date and refunds will be issued.
I, the undersigned, have read, understood, and agreed to the terms listed above:
* Signature: __________________________________ Date: _________________
6. Print this form and mail or fax, with payment or PO, to:
Making Math Real Institute
6936 Bristol Drive
Berkeley, CA 94705
FAX: 510-528-9060