Skokie and Niles Township SEED Application 2022-2023

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Would you like to join a community SEED seminar? Please complete this form between August 1-26, 2022, and we will confirm your status by September 7. Applications submitted outside this timeframe will not be considered. Priority will be given to people who live or work in Skokie/Niles Township, or have a student who will be enrolled in a Skokie/Niles Township school during the upcoming school year.

Attendance is very important, so if you know you are going to miss more than one session, this is not the year for you to participate in SEED.

Note that you will not be able to save your application partway through and return to it. Please contact SEED @skokielibrary.info if you have questions about this application or SEED.

First Name *

Last Name *

Email address *

Phone number *

Please use this format ###-###-####

Home address *

Include street address, city, zip code

Community Organization Affiliation *

If you are affiliated with an organization which serves Skokie or other Niles Township community, or have a child who attends a Skokie/Niles Township school, please indicate the organization here.

Current Community Role(s) (e.g., teacher, employee, parent, volunteer, resident)

Employer/Board information

If you are participating as an employee or board member of an organization serving Skokie or a Niles Township community, your organization will be charged $300 in tuition. Your acceptance in SEED will be contingent on confirmation by your organization of their approval. Please provide the name and email address of your supervisor/contact person below. (NOTE: IF YOU ARE APPLYING AS AN INDIVIDUAL, THERE IS NO FEE.)

Are you interested in receiving continuing education credits (CPDUs) as a licensed educator?

Yes

Other:

Clear selection

Are you interested in receiving continuing education credits (CEUs) as a licensed speech-language pathologist, occupational therapist, or social worker?

Yes

Clear selection

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