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The Long Island Institute...Where the Best and Brightest of LI's Educators Come to Further Their Education
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(an affiliate of Brooklyn College) Registration Form Po Box 180, Smithtown, N.Y. 11787 631-473-8500 TUITION: $650 for Brooklyn College Summer Courses OR $90.00 per in-service credit ($270.00 for a 3 credit course). Make checks payable to: Long Island Institute of Professional Studies or LIIPS. Please complete ALL sections of the registration form and mail to the address above. You can also call your registration in on the phone. A minimum deposit of $50.00 (refundable or transferable) per course must accompany all registrations. All previous discounts apply to In-Service courses. New In-Service students are automatically entitled to a $20.00 discount off their first course with us. No discounts apply to Brooklyn College Graduate courses. BC tuition must be paid @ or before the first class. Did you pre-register over the phone? yes or no Have you taken a course with us before? yes or no How did you hear about LIIPS?_________________________________________________________ SESSION: FALL SPRING SUMMER (please circle) Name___________________________________________________________ E-mail Address__________________________ Street Address___________________________________________________________________________________________ Town ______________________________ Zip Code___________________ Home Phone(_______)_________________ School District_____________________________________ School Phone(_______)___________________________ Course Title & Number (if applicable) Site Circle: Graduate or in-service Start Date ___________________________________________ _______ G or IS ________ __________________________________________________ ________ G or IS ________ __________________________________________________ ________ G or IS ________ Site = Smithtown (ST), Nassau (NS), Suffolk (SS) or Riverhead (RV) CREDIT CARD Payment: MC, VISA, DIS or AMEX (please circle). Prepay in full before the first class session and take $20.00 off (applies to 3 credit In-Service courses only). Also, remember if you are a new student and this is your first In-Service course with us you are entitled to a $20.00 "new" student welcome discount! Note: No discounts on Brooklyn College Graduate courses. credit card # ____________________________________________________________ exp._______________ Total to be charged to your credit card: $ __________ Signature: ________________________________________ (required if using a credit card) Please note: Graduate classes will be limited to 30 students. Full payment must be received by the last class of the course in order to receive credit. In-person payment can be accepted at the class site. Please assume your registration is accepted unless otherwise notified. |