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2020-2021 CSRDE Webinar Selection Form Institution: FORMTEXT ?????Preferred Salutation: (please check one) Dr. FORMCHECKBOX Mr. FORMCHECKBOX Mrs. FORMCHECKBOX Ms. FORMCHECKBOX Miss FORMCHECKBOX Name: FORMTEXT ?????Title: FORMTEXT ?????Address: FORMTEXT ?????City: FORMTEXT ?????State/Prov: FORMTEXT ?????Zip/Postal Code: FORMTEXT ?????Phone: FORMTEXT ?????Fax: FORMTEXT ?????E-mail: FORMTEXT ?????All webinars are at 1:00-2:00 Central Time.Full descriptions of webinars are available at one or more. Registrants from CSRDE member institutions receive discounts. See Webinar Registration Form for details. If a webinar has already been completed, you may order the materials on a CD. The cost will be the same as attending the webinar.DATETITLECHECKDecember 9, 2020University College at Montclair State University: A Catalyst for Change to Improve Student Retention FORMCHECKBOX January 13, 2021The Changing Family Dynamic and Student Success: A Theoretical Framework FORMCHECKBOX February 3, 2021Breaking Down Barriers to Support Student Success, Equity, and Completion FORMCHECKBOX February 17, 2021Integrate Early Alert and Case Managed Advising for Maximum Results FORMCHECKBOX March 10, 2021Enhancing Persistence for Students on Academic Probation Utilizing Peer Mentors FORMCHECKBOX April 14, 2021A Second Chance at Success: Retention Through Provisional Admissions Programs FORMCHECKBOX April 28, 2021The Use of Predictive Modeling to Drive Specific Student Interventions That Improve Retention FORMCHECKBOX May 12, 2021Strategies of Implementing a Pipeline Program Rooted in Culturally-Relevant Pedagogy FORMCHECKBOX June 16, 2021Insights From Academic Life Coaching: Using Psychosocial Factors to Inform Life Coaching Interventions FORMCHECKBOX July 14, 2021Data Cartography at Tulane University: Mapping Your Data Through a Theoretical Lens FORMCHECKBOX August 11, 2021Cultivating Identity Development Among Underprepared College Students in a First-Year Learning Community FORMCHECKBOX September 15, 2021Predicting Minority Student Dropout Using Data Mining Techniques FORMCHECKBOX Registrations may be paid by University check, VISA, MasterCard, Discover or American Express. Purchase orders will be accepted from universities. Registration, substitution and cancellation deadline is 3 business days prior to the day of webinar. All faxed and mailed registrations must be accompanied by a payment or purchase order. No refunds after cancellation deadline. ~ All Webinars are viewed live and recorded for Podcast. Registrants to each Webinar will also have unlimited access to its Podcast for five weeks. The Consortium for Student Retention Data Exchange (CSRDE) at the Center for Institutional Data Exchange and AnalysisThe University of Oklahoma OutreachWebinar Registration Form (Please type or print clearly and include the webinar selection form.)Registrant Name: FORMTEXT ?????Contact Phone: FORMTEXT ?????Name of Institution: FORMTEXT ?????Contact Email: FORMTEXT ?????Webinar fees for registrants Check OneDirections: Registrants from CSRDE member institutions only may register for webinars at discounted rates. You may check your institution’s membership at: FORMCHECKBOX Registrant’s Institution is a CSRDE member institutionIndividual Webinars ($129 each if purchased individually)Indicate # of Webinars: FORMTEXT ?????$ FORMTEXT ?????Block Webinars ($79 each if purchasing in block of 3 or more. Must be purchased at the same time for discount to apply)Indicate # of Webinars: FORMTEXT ?????$ FORMTEXT ????? FORMCHECKBOX Registrant’s Institution is not a CSRDE member institutionIndividual Webinars ($229 each)Indicate # of Webinars: FORMTEXT ?????$ FORMTEXT ?????TOTAL DUE:$ FORMTEXT ?????Select Payment Option: FORMCHECKBOX Check Payable to:The University of Oklahoma, C-IDEAFederal ID #: 73-1377584 Mail to:The University of OklahomaPlease Note:We cannot accept credit card information via emailAttn: C-IDEA1700 Asp Avenue, Room B1Norman, OK 73072-6400 FORMCHECKBOX Credit Card Call-in Call:405-325-6034 FORMCHECKBOX Fax Credit Card Fax to:405-325-7164 Card Type: FORMCHECKBOX Visa FORMCHECKBOX MasterCard FORMCHECKBOX Discover FORMCHECKBOX American ExpressCardholder Name: FORMTEXT ????? FORMTEXT ?????Cardholder Phone: FORMTEXT ?????Cardholder E-mail: FORMTEXT ????? FORMTEXT ?????Signature: FORMTEXT ????? FORMTEXT ?????Credit Card Number: FORMTEXT ?????Expiration Date: FORMTEXT ?????Cancellation Policy and Substitution Policy. Registration and webinar substitution deadline is 3 days prior to day of webinar. No refunds will be provided for cancellations of any webinar purchased as part of a package or in a block. Refunds minus 20% cancellation fee will be made for individually purchased webinars if the cancellation request is received by the CSRDE Office in writing at least 3 business days before the day of the event. No refunds are available for events for which login information has been distributed to registrants. CSRDE reserves the right to cancel and reschedule webinars. Registrants unable to attend a registered session will be able to view a recording of the session for five weeks after the session. ................
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