APPLICATION & FEES - 2008 KELLOGG INSTITUTE

The correct fees are now posted for the 2008 Institute.

Please print form, complete and mail to:  Kellogg Institute, ASU, PO Box 32098, Boone, NC 28608.

Important - THE APPLICATION PACKAGE SHOULD INCLUDE: 

1. An application form completed in full.
2. A non-refundable $250 deposit, AND
3. A brief statement of your objectives for attending the Kellogg Institute.

Notification of acceptance will be made upon receipt of the application package.

APPLICATION:

Mr.____ Mrs. ___ Ms. ___ Miss ___ Dr. ___

Name__________________________________________  Title________________________

Name you wish to be called ____________________________

Institution__________________________________________________________

Institution Address___________________________________________________

Home Address _____________________________________________________

Institution Phone ____________________ Home Phone ____________________

Fax # ____________________________ Email Address ___________________

T-shirt size: S___ M___ L ___ XL ___ XXL __________

Type of Institution:  Public ___ Private ___ Two-year____ Four-year ___

Please check all appropriate position(s) you hold:  Administrator___ Counselor ___

    Instructor ___ Other (please specify)________________________________

Number of years you have been in Developmental Education ________

Major responsibility/roles within last five year: ______________________________

_________________________________________________________________

Please list some of your professional interests/expertise:________________________________

_________________________________________________________________________

Please list some of your personal interests:__________________________________________

__________________________________________________________________________

How did you learn about the Kellogg Institute?_______________________________________

Please list 2 individuals, including title, who should receive the congratulatory letter of certification completion:

1._______________________________________________________________________

2._______________________________________________________________________

TRAVEL INFORMATION

Driving arrangements should be made to arrive at the Institute by 4:00 p.m. on Saturday, June 28, 2008.
Flight arrangements should be made to arrive at Charlotte Douglas International Airport no later than 2:00 p.m. on Saturday, June 28, 2008.

Email questions to kellogg@appstate.edu or hoffmankm@appstate.edu
phone (828) 262-3057 or fax (828) 262-7183

KELLOGG INSTITUTE FEES

REQUIRED FEES:

1.	INSTITUTE FEE		$1180.00
2.	RESIDENCE HALL ROOM AND BOARD		+$1051.50
3.	APPALACHIAN STUDENT I.D.		+7.00
4	SUPERVISED PRACTICUM:    All participants must enroll in HE 6900 during the summer session for 3 semester hours to cover supervision.	(enter amount below)
	IN-STATE	$498	_______
	OUT-OF-STATE	$1317	_______
5.	ASU PROCESSING FEE*		+$45.00
6.	TOTAL REQUIRED FEES		______
7.	OPTIONAL GRADUATE CREDIT FEES**	(see below)
	IN-STATE	$166 per credit hour	______
	OUT-OF-STATE	$439 per credit hour	______
8.	SGA REQUIRED FEE
	3 CREDIT HOURS	$0.13 total	______
	6-9 CREDIT HOURS	$0.25 total	______
9.	TOTAL ALL FEES:		$_______
10.	LESS $250 Non-Refundable Deposit		- $250.00
11.	BALANCE DUE: (by 4/15/08)		$______

THE BALANCE OF ALL FEES IS DUE APRIL 15, 2008. Due to the high number of KI applicants, non-payment by this date will result in a forfeiture of your Kellogg acceptance to the next applicant on the waiting list.

 *ASU PROCESSING FEE: This is for new applicants to only. If you have previously applied for enrollment to Appalachian State University, you do not need to pay this fee.

**OPTIONAL GRADUATE CREDIT FEES WORKSHEET: Graduate credit for the summer seminars is optional. Up to 6 hours of credit may be earned by enrolling in HE 6090 (3 hours) - Developmental Education in Postsecondary Institutions and/or HE 6631 (3 hours) - Teaching and Learning in Postsecondary Institutions.

If no graduate credit is desired, do not complete this section:

HE 6090 - Developmental Education in Postsecondary Institutions  (3 hours)	____ Hours
HE 6631 - Teaching and Learning in Postsecondary Institutions (3 hours)	____ Hours
Total #	____ Hours

Summer Tuition:* Multiply total graduate credit hours by rate:

In-state =	$166 per hour	$_________
Out-of-state =	$439 per hour	$_________
	Total Optional Fees (place this amount on Line 6 above)	$_________

Explanation of Fees:  Institute registration fees cover all materials required for Institute sessions, faculty leadership, transportation to and from Charlotte International Airport, and the opening and closing dinners.  Residence hall room and board includes a single occupancy room, a $240 meal plan, linens for four weeks, and local telephone service.

Please make checks payable to the Kellogg Institute. Wire transfers are not accepted.

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You may pay your tuition and fees via Visa or MasterCard:

Visa________ MasterCard_______

Please specify: _____ Company Card _____ Personal Card

Credit Card Number_______________________________

Expiration Date____________ Signature_____________________

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