South Cook Intermediate Service Center

District Institute\Parental Institute\ Parent-Teacher Conference Application

Please fill out the form below or Download and complete a PDF version and email to institute@s-cook.org or FAX to (708) 754-8687.

Fields marked with an asterisk (*) are required.

Application For*

District Name / Number*

Number of Participants*

Date of Institute*

To Be Held At*

PLANNING COMMITTEE MEMBERS: (50% must be classroom teachers, 25% administrators and 25% school service personnel.)

Teachers - 50%

Administration - 25%

School Service Personnel - 25%

Theme of District Institute*

Institute Date Objectives*

If you are providing professional development (PD) hours for any part of this Teacher Institute, you must also fill out and keep on file a copy of the
“Approved Professional Development Provider Activity Summary (73-58)”.
https://www.isbe.net/Documents/73-58-approved-pd-provider-activity-summary.pdf

Chairperson of Planning Committee (Name)*

Date*

District Superintendent*

Date*

Agenda Upload
(2MB Limit for Upload)

Email for Confirmation of Receipt

Enter Email

Confirm Email