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									                                                                                                           Non-Profit Org.

    Summer 2010 Course Catalog                                                                             US POSTAGE
                                                                                                               PAID
                                                                                                           Northampton,
                                                                                                                MA
                                                                                                           Permit No. 47


                                                                     Hampshire Educational Collaborative
                                                                     97 Hawley Street
                                                                     Northampton, MA 01060
                                 Become a
                                                                     FORWARDING SERVICE REQUESTED
                                 licensed educator,
                                 renew your educator
                                 license, add an


          Quick.
                                 additional license.




Affordable.
Practical.
                   Statewide.
                                                                     English as a Second Language . Reading
                                                                     Special Education . Mathematics . Math/Science
                                                                     General Science . Earth Science . Biology
                                                                     Chemistry . Physics . School Administration




                                                                     Teach.                                       COURSES START
                                                                                                                  JUNE 26




                                                                     www.TeachInMass.org
PDPs, graduate credit, Master’s Degree and CAGS options available.
N E WS                                                             Meet Our Instructors


Important Email Alert!!                                            Matthew Beyranevand is a mathematics teacher and professional development
Are you having trouble receiving or opening emails from            presenter for the Lowell Public Schools.
us? Email systems have varying levels of security in order         Nancy Cheevers is a National Board Certified English/Language Arts teacher in
to filter unwanted mail, and may be blocking unfamiliar            the Northampton Public Schools.
or suspected email addresses. To ensure that you receive
important email from us (registration acknowledgements             Sharon Clark is a Curriculum Instruction Specialist in the Lowell Public Schools
and confirmations, practicum information, etc), please:            who has presented extensively in areas ranging from reading to collaboration
    1. check your email spam folder regularly and mark any         among teachers.
       messages from fm@collaborative.org as 'not spam'            Ann Colligan is a Math Coach in the Leominster Public Schools who has
    2. add fm@collaborative.org to your address or                 developed innovative math and science curricula
       contact list
                                                                   Soraya DeBarros is a math coach in the Brockton Public Schools, where she
Changes to the English as a Second                                 served previously as an English Immersion teacher.
Language (ESL) Licensure Program                                   Les Edinson is a Support Facilitator for the Pioneer Valley District and School
We have made important enhancements to the course                  Assistance Center. Recently retired from the public schools, he is an experienced
structure of the ESL Initial License program.                      principal who has been successful in both urban and rural environments.
    1. Each of the current two-credit courses in the program       Martha Harrington retired from a career as a special education teacher and
       will become three-credit courses beginning Fall 2010.       consultant in the Brookline Public Schools.
    2. The two credit “Principles of Second Language
                                                                   Rick Last is a Curriculum Implementation and Professional Development
       Acquisition” will not be offered during the Summer
                                                                   Consultant for the Collaborative.
       term, but will be offered as a three-credit course in the
       Fall term, beginning Fall 2010.                             Sara Lowe-Bouchard is a speech pathologist and consultant with a particular
    3. The course “Assessment for Reading Instruction” will        expertise in assistive technology.
       no longer be a requirement; rather, the new three-          Ruthann Melancon is Principal of the Elm Park Community School in Worcester
       credit “Teaching and Assessing Reading and Writing
                                                                   and a former education specialist for the Massachusetts Department of
       for English Language Learners” will replace that course,
                                                                   Elementary and Secondary Education.
       offered in the Fall term.
    4. All students currently enrolled in the English as           Mary Morgan is a grant coordinator and Title I teacher for the Wareham Public
       a Second Language licensure program, and those              Schools.
       students currently taking courses in anticipation of
                                                                   Jennifer Rickard is a Lead Elementary Special Education teacher for the
       enrollment, will receive personalized notification of the
                                                                   Shrewsbury Public Schools.
       changes and their course of study. No student will be
       penalized for having already completed the two-credit       Sanford Roth is a veteran classroom and special education teacher who is a
       courses as proscribed by their program of study.            Curriculum Specialist at the Collaborative.

Contemporary Issues in Education Course                            Richard Seelig is a retired math and science teacher. He taught at the Springfield
                                                                   Academy for Excellence, an alternative school in the Springfield Public Schools.
As previously announced, this course will not be offered
during the Summer of 2010, but will be available during            Sue Smith is recently retired from her position a Facilitator/District Support
the Summer of 2011.                                                Specialist for Lowell Public Schools. She is an adjunct faculty member at UMass/
                                                                   Lowell and course developer and instructor at Middlesex Community College.
New Initial License Programs Coming!
                                                                   Jennifer Traverso is a reading specialist at Baldwinville Elementary School in the
Watch for announcements regarding new Initial license
                                                                   Narragansett Regional School District. She has also served as a consultant to
programs for middle and high school History and English
Language Arts and Middle School Humanities, with                   school districts and the Massachusetts Department of Education.
projected start for Spring 2011.
We are also awaiting approval from the Massachusetts
Department of Elementary and Secondary Education for
two new programs: a combined Elementary and Elementary
Mathematics Initial License and a combined Elementary
and Elementary Science Initial License.




                                                                                                        Rick Last | Nancy Cheevers
2
                                         Teacher of English as a Second Language (PreK-6) (5-12)


                                         Teacher of Middle School Mathematics (5-8)
    We offer educator
 preparation programs                    Teacher of Middle School Math/Science (5-8)

   for an Initial license                Teacher of Mathematics (8-12)

         in these areas                  Teacher of General Science (5-8)
                                         Teacher of Biology (5-8) (8-12)
                                         Teacher of Chemistry (5-8) (8-12)
  Courses and requirements for
     the programs represented            Teacher of Earth Science (5-8) (8-12)
      by each icon are detailed          Teacher of Physics (5-8) (8-12)
                on our website.
      Administrator preparation          Teacher of Students with Moderate Disabilities (PreK-8) (5-12)
            programs are now
        available statewide as
                                         Reading Specialist (All Levels)
        hybrid-online courses.

                                         Administrator (PreK-6) (5-8) (9-12): Principal/Assistant Principal
                                         Administrator (All Levels): Superintendent/Assistant Superintendent
                                         Administrator (All Levels): Supervisor/Director
                                         Administrator (All Levels): Special Education Administrator




                                         To enroll in a licensure program or for more information about our
                                         programs, please visit www.TeachInMass.org or contact us at:
                                         413-586-4900 or 800-278-4244
                                         E-Mail: licensure@collaborative.org




                                                                                                                         Affordable. Practical. Statewide.
         A program of the Hampshire
                                         Information Sessions
         Educational Collaborative, a
nonprofit educational service agency     Opportunities to learn more about our educator licensure programs will be
 serving schools and school districts,   scheduled at locations throughout the state during the coming months. Dates
     communities, and students with      and locations are posted on our website as they are confirmed.
              diverse learning needs.
                                         FIRST FRIDAYS IN NORTHAMPTON (4-5pm)
Hampshire Educational Collaborative
                                         Regular information sessions are held on the First Friday of every month from
     Educator Licensure Programs         4pm to 5pm at the HEC main office at 97 Hawley Street, Northampton. Bring
                  97 Hawley Street       your questions and sit down with someone to discuss your options. We can help
           Northampton, MA 01060         you to map out your program so you can begin the path to a new career.
     413-586-4900 . 800-278-4244           Spring and Summer 2010 dates: April 9*, May 7, June 4, July 9*, August 6
                   413-586-2878 fax
                                           * Due to holidays the April and July sessions will be on second Fridays
  e-mail: licensure@collaborative.org
                                         School district information sessions may be scheduled on request.
   www.TeachInMass.org


                                         Empowering Educators, Inspiring Learners Since 1974
                                                                                                                                                     3
 C O URSE OPTIONS                                      The affordable, practical route to an Initial License.

HEC licensure courses are designed to meet the         The Hampshire Educational                      exciting and grounded in experience.
diverse needs of teachers and career-changers today,   Collaborative (HEC) is a respected leader      Courses are offered throughout the year
utilizing innovative videoconferencing technology      in professional development for PreK-          and participants enjoy a small-school
to bring exceptional programming to convenient         12 educators, with over thirty years of        learning environment that promotes
locations across the state.                            experience in meeting the specific needs       access and support.
• Any HEC licensure course may be taken as part        of teachers, administrators, and school        Each HEC license preparation program
  of a Licensure Program or as an individual course    districts. The distinctive insights we have    consists of six courses and a practicum.
                                                       gained through this work have guided us        Many people complete these programs
• Courses may be taken for:                            in developing innovative, high quality         in eighteen months while continuing to
    – Professional Development Points (PDPs)           license preparation programs that are          work full time, although enrollees may
    – Graduate Credit (additional cost)                designed by educators, for educators. The      take up to five years to complete the
                                                       knowledgeable professionals who teach          program. Through our higher education
    – Master’s Degree or CAGS from Fitchburg State
                                                       our courses are experienced in their fields    partner, Fitchburg State College, licensure
      College (additional required courses and cost)
                                                       and understand the challenges facing           candidates may also elect to receive
                                                       teachers today—because they share them.        graduate credit or complete an MEd or
                                                       HEC licensure programs provide a quick,        CAGS. Those already working in schools
C O URSE LOCATIONS                                     practical, and cost-effective route to an      have the opportunity to integrate their
                                                       Initial License as a teacher or school         practicum into their work.
                                                       administrator that is both intellectually
Dalton
Nessacus Middle School
35 Fox Road, Dalton, MA 01226                          Earn your Master’s in Education or Certificate of
Lowell                                                 Advance Graduate Study (CAGS) through
C.W. Morey Elementary School
130 Pine Street, Lowell, MA 01851
                                                       Fitchburg State College
New Bedford
New Bedford Public Schools Central Office
455 County Street, New Bedford, MA 02740
Worcester                                                                                In collaboration with Fitchburg State College (FSC),
                                                       For graduate program
Quinsigamond Elementary School                         application procedures and        licensure courses taught at all of our locations across
14 Blackstone River Road, Worcester, MA 01607          more information, contact:        Massachusetts can also be taken for graduate credit.
*Pioneer Valley Area                                   Beverly Streeter                  • Graduate credits from FSC are available for each
                                                       HEC Licensure Programs              HEC Licensure Program course for an additional fee.
Holyoke
                                                       413-586-4900 x145                 • Registration for graduate credit and payment to
Holyoke Community College                                                                  FSC occurs at the first session of every course
                                                       bstreeter@collaborative.org
Kittredge Center/Donahue Building
303 Homestead Avenue, Holyoke, MA 01040                At Fitchburg State College:       Graduate credits earned through HEC Licensure
Northampton                                                                              Program courses may be used toward a Master’s
                                                       Stephen Hemman
                                                                                         Degree (MEd in Curriculum & Teaching) or,
Hampshire Educational Collaborative                    Program Coordinator
                                                                                         for those who already have a Master’s Degree, a
97 Hawley Street, Northampton, MA 01060                978-821-2890                      Certificate of Advanced Graduate Study (CAGS)
                                                       shemman@fsc.edu                   from Fitchburg State College.
Directions are available at: www.TeachInMass.org
                                                       Kathy McCoy
                                                                                         A typical plan of study for the MEd includes:
*While we endeavor to meet students’ site              Graduate & Continuing Ed.
 preferences, we reserve the right to move courses     Admissions Counselor              • Licensure@HEC courses required for licensure
 between locations in the Pioneer Valley area to       978-665-3136                      • A seminar taken in conjunction with the practicum
 accommodate enrollment needs.                         kmccoy@fsc.edu                    • 18 credits in addition to requirements for licensure

                                                       TO EARN A GRADUATE               In conjunction with Fitchburg State College, the
                                                       DEGREE YOU MUST                  Collaborative prepares Educational Leaders who are
                                                                                        KNOWLEDGEABLE, ETHICAL, SKILLFUL,
                                                       SUBMIT A PROGRAM
                                                                                        and CARING.
                                                       APPLICATION TO FSC.
                                                       EARLY ENROLLMENT IS

4
           www.TeachInMass.org                         ENCOURAGED.                                          G R A D U AT E C R E D I T
                                                                                                                     New hybrid online options for our
SUMMER 2010                                                                                                          Northampton-based Administrator
                                                                                                                     program offer increased flexibility
                                                                                                                     and access.

Curriculum Leadership and Evaluation
This course is designed for school administrators who must become knowledgeable about curriculum
development and program evaluation. The role of the administrator as a decision-maker and as an
instructional leader is explored. Emphasis is placed on program development and evaluation, reflecting the
various cultural and ethnic minority groups children and youth represent. Additionally, practical applications        Level: K-12
of programs, as well as the application of evaluation models and techniques, are investigated. A field-based          67.5 PDPs | 3 Graduate Credits
experience is required for this course.                                                                               Course required for Licensure Program

Instructor:             Les Edinson
                                                                                                                      This is a hybrid online course.
Hybrid online course: Online coursework plus 3 class meetings in Holyoke (7/12, 8/2, and 8/16/10)
                                                                                                                      3 in-person sessions (Mondays):
Register by:            June 23, 2010 ($50 late fee applies after this date)
                                                                                                                      Jul 12 (8am-1pm), Aug 2 (8am-2pm),
                                                                                                                      and Aug 16 (2-7pm)
                                                                                                                      in Holyoke
                                                                                                                      Online coursework Jul 12-Aug 16
Bureaucracy in Education
This course focuses on how participants have experienced school—as students, as teachers, and as
leaders—and how the organization of schools and districts creates those experiences. The rules under
which schools operate, the intention of the educational reforms and movements that underlie those rules,
and the interaction between those rules and individual goals are examined. The course requires writing                Level: K-12
similar to that required in schools and districts as well as writing that draws on students’ experiences with         67.5 PDPs | 3 Graduate Credits
schools. Participants will gain an understanding of some of the areas of rule setting within an organization          Course required for Licensure Program
including, but not limited to, collective bargaining, state and federal regulations, broad expectations
regarding education reform, and school district budgets.
                                                                                                                      This is a hybrid online course.
Instructor:             Ruthann Melancon                                                                              3 in-person sessions (Saturdays):
Hybrid online course: Online coursework plus 3 class meetings in Holyoke (6/26, 7/31 and 8/14)                       Jun 26, Jul 31, and Aug 14
Register by:            June 9, 2010 ($50 late fee applies after this date)                                          (9:30am-12:30pm)
                                                                                                                     in Holyoke
                                                                                                                      Online coursework Jun 26-Aug 20



Practicum
The practicum is required for all licensure programs and is                            “I loved the class. I can't wait to go back to work!”
included in the program cost. If you have completed at least 4
courses and all of your enrollment documents, you may register                          “Good review of teacher evaluation procedures...
for the practicum.                                                                           very helpful info on expeditionary learning...”
If you already possess an Initial/Professional License and are
seeking an additional license that requires a practicum (except
Reading Specialist and Administrator licenses), the practicum
fee is $1800.
Practicum registration forms are available on our Forms and
Documents page at www.TeachInMass.org.
   Completed forms should be mailed to:
   Practicum Coordinator
   HEC Licensure Programs
   Hampshire Educational Collaborative
   97 Hawley Street
   Northampton, MA 01060

For questions, please write to:
practicum@collaborative.org



                                                                                                                                                              5
SUMMER 2010

Working with the Range of Students in Mathematics
This course focuses on teaching mathematics to diverse student groups, including, but not limited to,
students with special needs, targeting the “big ideas” of mathematics in order to help students develop
a strong sense of understanding what is behind the numbers. Participants observe, analyze, and define
children’s mathematical learning needs utilizing a variety of evaluative techniques, both informal and formal,             Level: K-12
and to identify the essential knowledge, understandings, and skills embodied in a diverse mathematical                     67.5 PDPs | 3 Graduate Credits
curriculum. The data obtained through the assessment process assists in the planning and implementation                    Course required for Licensure Program
of plans for learning including, but not limited to, Individualized Education Plans (IEPs). The evaluation
of learning styles (both self and student) is central to this process and is investigated along with a variety of          Traditional classes:
techniques that can be incorporated into instruction of mathematics. Related current research is examined.                 Jul 26, 27, 28, 29 (Mon-Thur, 2-7pm)
Explicit relationships with the Massachusetts Curriculum Frameworks are explored within the context of                     Aug 2, 3, 4, 5 (Mon-Thur, 2-7pm)
each discipline. Using this common set of goals, participants create grade level specific lessons and activities.          Sept 24 (Fri, 4:30-7:30pm)
Instructors include:     Matthew Beyranevand, Ann Colligan, Rick Last
Traditional classes in: Dalton, Holyoke, New Bedford, Northampton, Lowell, Worcester
Register by:             July 7, 2010 ($50 late fee applies after this date)

Working with Individuals with Special Needs
Based upon research, personal experience and coursework, participants will analyze educational issues,
models, theories, and philosophies regarding individuals with special needs. We will examine disabilities from
various perspectives, including medicine, behavior, psychology, and education, and we will study inclusion
and other successful approaches for understanding and working with people who are disabled. Participants                   Level: K-12
will learn how to identify behavior that interferes with achievement, and appropriate interventions including              67.5 PDPs | 3 Graduate Credits
medicine, counseling, and teaching strategies will be discussed. The historical foundation of current practices            Course required for Licensure Program
in special education will be examined, and current state and federal rules and regulations governing the
provision of special needs services will be considered. Community resources, organizations, publications, and              Traditional classes:
journals will be identified, and participants learn how to make effective referrals to resources in their own              Jun 28, 29, 30; Jul 1 (Mon-Thur, 2-7pm)
local community.                                                                                                           Jul 6, 7, 8, 9 (Tue-Fri, 2-7pm)
Instructors include:        Martha Harrington, Sara Lowe-Bouchard, Jennifer Rickard, Susan Smith
Traditional classes in: Dalton, Holyoke, Lowell, New Bedford, Northampton, Worcester
Register by:                June 9, 2010 ($50 late fee applies after this date)


Curriculum and Assessment for Teachers
                                 This course is designed to help teachers become knowledgeable about standards-
    Course is offered in a       based curriculum development and program evaluation. We will explore the
    choice of formats:           instructional role of the teacher within a framework of distributed leadership, with
    • Traditional Classes        emphasis on instructional approaches that help all children achieve high standards.        Level: K-12
    • Hybrid Online              Teachers who complete this course successfully will approach teaching as leaders in        67.5 PDPs | 3 Graduate Credits
                                 the field of curriculum.                                                                   Course required for Licensure Program

Instructors include:        Matthew Beyranevand, Sharon Clark, Les Edinson
                                                                                                                            Traditional classes:
Traditional classes in: Northampton, Lowell
                                                                                                                            Jul 12, 13, 14, 15 (Mon-Thur, 2-7pm)
Also hybrid online:         Online coursework starting 6/26, plus 3 class meetings in Worcester (7/10, 7/24, 8/7)
                                                                                                                            Jul 19, 20, 21, 22 (Mon-Thur, 2-7pm)
Register by:                June 9, 2010 ($50 late fee applies after this date)                                             Oct 1 (Fri, 4:30-7:30pm)
                                                                                                                            Hybrid online option:
                                                                                                                            3 in-person sessions (Saturdays)
                                                                                  A $50 late fee will be applied for all
                                                                                                                            July 10, 24 and Aug 7 (1-4pm)
                                                                                  registrations received after the date
                                                                                  noted in each course description.
                                                                                                                            in Worcester
                                                                                  Registrations will be accepted on         Online coursework: June 26-Oct 1
                                                                                  a first-come, first-served basis.
                                                                                  A maximum class size will be set
                                                                                  for each course.
                                                                                  Hampshire Educational Collaborative
                                                                                  may choose to provide instruction
6           www.TeachInMass.org                                                   to low enrollment courses through
                                                                                  alternate means of course delivery.
SUMMER 2010

Inquiry Science
This course focuses on learning science through inquiry. Specifically, it considers how teachers can help
students acquire knowledge of the material world through direct investigation. It will acquaint teachers with
the process of scientific inquiry described in the Massachusetts Curriculum Frameworks and with standards-
based approaches to science education. Rather than survey the wide range of topics that can provide subject              Level: K-12
matter, participants will pursue a deeper understanding of specific topics through their own investigations.             67.5 PDPs | 3 Graduate Credits
They will also consider ways to facilitate student explorations of these topics. Participants will evaluate              Course required for Licensure Program
published curriculum materials in light of the Massachusetts Curriculum Frameworks and reflect on the
varied approaches to subject matter taken by other teachers. Strategies for assessment and evaluation will be            This is a hybrid online course.
introduced. Participants will be expected to complete readings, written assignments, observations of natural
                                                                                                                         3 in-person sessions (Saturdays):
phenomena, visits to middle school science classes, and a curriculum project.
                                                                                                                         Jun 26, Jul 31 and Aug 21
Instructor:             Richard Seelig                                                                                   (9:30am-2pm)
Hybrid online course: Online coursework plus 3 class meetings in Worcester (6/26, 7/31 and 8/21)                         in Worcester
Register by:            June 9, 2010 ($50 late fee applies after this date)                                              Online coursework Jun 26-Oct 1


Language Learning and Literacy
                             The purpose of this course is to prepare teachers of reading with a broad
 Course is offered in a      understanding of approaches to the study of language, linguistic concepts
 choice of formats:          applicable to the study of English, concepts regarding language learning, and
                                                                                                                         Level: K-12
  • Traditional Classes      the ability to use this knowledge in the context of classroom teaching and
                             program development. This course primarily focuses on the social context of                 67.5 PDPs | 3 Graduate Credits
  • Hybrid Online
                             language, including dialect variations such as Black English, and how home and              Course required for Licensure Program
community experiences influence language learning in school. As a result of this course, students will have an
understanding of how student background relates to language learning and, most importantly, how classroom              Traditional classes:
teachers, teachers of reading, and other professionals can promote language learning for all.                          Jun 28, 29, 30; Jul 1 (Mon-Thur, 8am-1pm)
                                                                                                                       Jul 6, 7, 8, 9 (Tue-Fri, 8am-1pm)
Instructors include:    Nancy Cheevers, Mary Morgan
                                                                                                                       Hybrid online option:
Traditional classes in: Northampton, Lowell
                                                                                                                       3 in-person sessions (Saturdays)
Hybrid online course: Online coursework plus 3 class meetings in Worcester (7/10, 7/31 and 8/14)                       Jul 10, 31 and Aug 14 (9:30am-12:30pm)
Register by:            June 9, 2010 ($50 late fee applies after this date)                                            in Worcester
                                                                                                                       Online coursework: Jul 10-Aug 20

Specialized Reading Approaches
                             This course is designed to assist participants in teaching intermediate students,
 Course is offered in a      including English language learners, to read and write and to use literacy skills for a
 choice of formats:          variety of purposes. Sessions will focus on implementing effective literacy practices
  • Traditional Classes      with groups of students, using observations of students’ reading and writing                Level: K-12
  • Hybrid Online            behaviors to effectively plan for different learners, and establishing a supportive,        67.5 PDPs | 3 Graduate Credits
                             well-managed environment for learning. Participants will gain experience in                 Course required for Licensure Program
observational assessments, lesson planning, guided reading, writing process, and language/word study.
Instructors include:    Sandy Roth, Jennifer Traverso                                                                  Traditional classes:
                                                                                                                       Aug 9, 10, 11, 12 (Mon-Thur, 8am-1pm)
Traditional classes in: Northampton
                                                                                                                       Aug 16, 17, 18, 19 (Mon-Thur, 8am-1pm)
Hybrid online course: Online coursework plus 3 class meetings in Worcester (6/26, 7/31 and 8/21)
Register by:            June 9, 2010 ($50 late fee applies after this date)                                            Hybrid online option:
                                                                                                                       3 in-person sessions (Saturdays)
                                                                                                                       Jun 26, Jul 31 and Aug 21 (1-4pm)
                                                                                                                       in Worcester
                                                                                                                       Online coursework: Jun 26-Aug 21

                                                                       “Excellent experience and intro to HEC
                                                              . ...an ideal facilitator—rigorous in expectations,
                                                            but flexible with our approach to learning. A very
                                                           well-informed, thoughtful instructor with extensive
                                                                     knowledge in the field and experience...»
                                                                                                                                                                 7
                                                                                                                             Summer 2010
                                                                                                                             COURSE SELECTIONS
                                                                            MAIL OR FAX
                                                                            REGISTRATION FORM TO:
                                                                            HEC Licensure Programs                           Unless noted as ‘Hybrid Online,’ courses are
                                                                            97 Hawley Street                                 conducted in a traditional class meeting format.
                                                                            Northampton, MA 01060
PLEASE PRINT CLEARLY AND                                                    Attention: Ann Paquette
                                                                                                                             Curriclum Leadership and Evaluation
COMPLETE EACH SECTION                                                       413-586-2878 Fax                                      Hybrid Online with 3 meetings in Holyoke
                                                                                                                             Bureacracy in Education
 C O U R S E R E G I S T R AT I O N




                                      Last Name                                                                                  Hybrid Online with 3 meetings in Holyoke
                                      First Name                                                                             Working with the Range of Students in Math
                                                                                                                                 Dalton          Holyoke       Lowell
                                      Home Address
                                                                                                                                 New Bedford     Northampton   Worcester
                                      City                                      State           Zip Code
                                                                                                                             Working with Individuals with Special Needs
                                      Home Phone with Area Code (                    )                                           Dalton           Holyoke        Lowell
                                                                                                                                 New Bedford      Northampton    Worcester
                                      Cell Phone with Area Code         (            )
                                      E-mail                                                                                 Curriculum and Assessment for Teachers
                                                                                                                                 Northampton      Lowell
                                      An e-mail address is required for all course participants.                                 Hybrid Online with 3 meetings in Worcester
                                      Please visit our website (www.TeachInMass.org) for information about free
                                      e-mail accounts that are available through Google, Yahoo, and other providers.         Inquiry Science
                                                                                                                                  Hybrid Online with 3 meetings in Worcester
                                      School or Work Name
                                                                                                                             Language Learning and Literacy
                                      School or Work Address                                                                     Northampton      Lowell
                                      City                                      State           Zip Code                         Hybrid Online with 3 meetings in Worcester

                                      School Phone with Area Code (                      )                                   Specialized Reading Approaches
                                                                                                                                 Northampton
                                      School Fax with Area Code (                )
                                                                                                                                 Hybrid Online with 3 meetings in Worcester
                                      School System
                                      Position                                               Grade Level

                                      All registration materials and forms are also available at www.TeachInMass.org




                                                                                                                                                                                www.TeachInMass.org
 WI T H D R AWA LS




                                      WITHDRAWAL POLICY (applies to all registrants)
                                      If it becomes necessary to withdraw from a course, you must notify the HEC Licensure Program office in writing,
                                      attention Ann Paquette. Written withdrawals forwarded via mail to the address below, by fax (413-586-2878), or e-mail
                                      (apaquette@collaborative.org) are accepted without penalty until 3:00pm, five working days prior to the first meeting
                                      date. After that date there will be no refunds or billing adjustments.
                                      I have read and I understand the above policy.

                                      Signed                                                                                      Date



                                      PAYMENT FOR INDIVIDUAL COURSES AND ANY                               Form of Payment:
  PAY M EN T




                                      LATE FEES MUST BE INCLUDED WITH REGISTRATION                              Check enclosed (Payable to Hampshire Educational Collaborative)
                                      (program enrollees are billed separately for tuition)                     PO #
                                      Participation Level:                                                      Credit Card:     Visa    MasterCard      Discover
                                             Licensure Program Enrollee                                    Card Number
                                                 Pay plan per Commitment Letter                            Expiration Date                                V Code
                                                 TTLT Grant Participant (prior approval required)          Name on Card
                                             Individual Course Registration                                Billing Address for Card
                                              $600 per course.
                                             $50 late fee enclosed for each late course registration       Total Amount to Bill to Card: $
 8
                                        TOTAL: $                                                           Signature

								
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