How To Register for Our 2006 Summer Workshops:

1. Fill out our Workshop Signup Form and Permission Slip, below. Please be sure to read the Permission Slip carefully, and provide any information about food allergies, medical conditions, and so on. This form ensures that you are informed about the use of tools and electronic equipment as well as the nature of the activities involved. It also helps us to match potential scholarship funds to qualified applicants, verify partners for "Attend with a Friend" options, and so on.

2. Pay for Tuition and any applicable Parts. Parts kits are provided at our approximate cost, after taking into account taxes, shipping, and one set of spares for every 10-15 kits provided. We are not a reseller and we do not attempt to make a profit on parts. By purchasing in modest quantities, we are usually able to provide very competitive pricing for the items in our parts kits.

Tuition must be paid for no later than the first day of class. Parts Kits must be paid for at least 3 weeks prior to the first day of class. Parts are ordered 2 weeks in advance. Prior to our order placement, a full refund can be provided, if you need to withdraw for any reason; hence, early payment is encouraged and ensures that a sufficient number of kits will be included in our order. After our parts order has been placed, though, you own the parts (even if you later withdraw from the workshop and receive a refund for your Tuition). Parts from kits may be exchanged in case of defects -- there are no returns.

If you would like to attend, but cannot afford to do so, due to financial hardship, please inquire about our Scholarship Programs. While funds are limited, we do our best to match potential sponsors with applicants. We do not request detailed financial information -- a note from your school Principal indicating that there is need (or similar documentation) will suffice. We do ask for a firm commitment to attend and complete the entire workshop, prior to awarding a scholarship. Confidentiality is assured: only major sponsors, instructors, and the applicant know who has been awarded a scholarship.

Please call us at 650-598-0105 if you have any questions about registration or payment, or encounter any difficulty with registration, or email us, at cto@learningtech.org.

If you are able to do so, please consider making a donation to enable a less fortunate student to also participate. All such donations are tax-deductible. Help us bridge the digital divide!


Learningtech Summer Workshops 2006 Signup Form

Yes! Please sign up me up for the following workshops!

Name of Student:
Gender: Male Female
Age:      Grade (as of 9/2006):     
Current School:
School Next Year:
Name of Parent/Guardian, if student is a minor:
Street Address:
City: Zip:
Phone (Daytime):
Phone (Evening/Weekend):
Email Address:
Emergency Contact:
Emergency Contact Phone:
Family Doctor Name:
Family Doctor Telephone:

Sessions:
Classroom Technology Officer [CTO]
Grades 5 - Adult
July 10 - 14, 10 am - 2:30 pm daily
High Tech High Bayshore
$299 Tuition/Lab Fee
Build a Computer!
Grades 6 - Adult (Ask about Family Rates!)
July 17 - July 21 10 am - 2:30 pm daily
High Tech High Bayshore
$299 Tuition

Purchase parts -- $850
yes
no (Partner will purchase parts and own the finished computer.)
If no, partner's name

Program a Robot!
Grades 6 - Adult
July 24 - July 28 10 am - 2:30 pm daily
High Tech High Bayshore
$299 Tuition
$350 Parts Cost (Siblings? Call about sharing a Robot!)
  Total: $.00

Payment Methods:
I am mailing my check or money order to:

The Miller Institute for Learning with Technology
751 Laurel Street, #411
San Carlos, CA 94070
I am paying via Kagi.
I am paying via PayPal.
I hereby request a scholarship, due to financial need.
Our family is eligible for the Federally-funded Free/Reduced Student Lunch program.

Comments:
Please note any food allergies, medical requirements, religious considerations here (see Terms below).


LEARNINGTECH.ORG WORKSHOP PERMISSION SLIP

Classroom Technology Officers -- Build a Computer -- Program a Robot

If student is a minor, permission slip must be completed by parent or guardian.

1. Student/parent/guardian hereby grants permission for student to participate in one or more of the aforementioned summer workshops. Student/parent/guardian has been advised that student might be using potentially dangerous tools, such as screwdrivers, soldering irons, or wire cutters, during some portions of some workshops, as well as working with intricate and potentially dangerous electronic equipment. Student/parent/guardian agree that he or she will promptly obey all instructor directions regarding the proper use of all tools and equipment, and always exercise caution to avoid injuries to self and others. The Miller Institute for Learning with Technology promises to exercise appropriate caution and good judgment, and to provide adequate supervision of student tool and equipment usage at all times. Student/parent/guardian agrees to hold harmless The Miller Institute for Learning with Technology and its personnel, as well as hosting school or other venue in the unlikely event of any accident or injury resulting from tool or equipment use. Permission is also hereby granted to obtain emergency medical attention for student, if needed. Any religious restrictions on medical treatment options, or special circumstances, such as need for certain medications, or allergies to certain medications, should be noted in the COMMENTS field of this form.

2. Student/parent/guardian hereby grants permission for student to bring home all binders, toolkits or other workshop materials upon successful completion and graduation from the program, with the understanding that, if tools are to be used at school in the fall, they will be immediately checked in with the appropriate teacher or school official, and never carried around campus without permission. Student and parent/guardian have been advised that schools consider even a small screwdriver in a backpack to be a concealed weapon. Students must not add Swiss army knife, Leatherman, or similar tools to their kits, should they plan to use their toolkit at school in the fall.

3. Student/parent/guardian understands that a small number of "retired" computers and/or electronic devices such as printers, scanners, software, or PDAs, may be given away during some workshops, either as prizes for excellent work and/or via a random raffle system, with every student having a fair chance of winning. These items are completely without warranty of any kind, and not necessarily intended for serious home use; they are provided only as further opportunities for the student to continue exploring and learning about technology. Permission is hereby granted, should student happen to win one of these prizes, to accept the item, with the understanding that they are "as is," with no warranty of any kind, expressed or implied. In particular, there are no exchanges and there is no follow-up technical support available. (A moderate number of short emails from workshop attendees, asking technical questions relating to workshop topics, including about such equipment, will usually be answered.) There is no guarantee that any student will receive any such retired equipment, since this aspect of the program varies with availability of donations of suitable items relevant to workshop topics. Sometimes such equipment has been provided through the generosity of RAFT (Resource Area for Teachers); other equipment might have been retired by local schools or otherwise donated by local families to The Miller Institute for use in its programs.

4. If student's family owns an older computer or other electronic device, in need of repair, student may be invited to bring it in during the CTO workshop, as a special project to pursue with instructor guidance. Please be certain to supervise any equipment selection for this activity! No guarantee or warranty is associated with this opportunity. Student/parent/guardian and equipment owner alike hereby agree to hold workshop organizers harmless for any and all damage to such equipment.

5. For Build-a-Computer workshops, parts purchased for the new computers being built are under warranty for one year, provided that student has obeyed all workshop instructions on installation and use. The computer itself carries no warranty, since it is "home built," but Miller Institute personnel will provide limited assistance to families during the warranty period, in the event of suspected parts failure, to facilitate troubleshooting and warranty parts replacement. Troubleshooting requests caused by installation of additional parts or software, beyond those provided or recommended, or due to misuse, are not covered and cannot be provided by the instructors, except at standard consulting rates. Normally, monitors are not included with the purchase of computer parts; however, used, working CRT-style monitors will be made available at no charge, so that each computer constructed by a student comes equipped with a working monitor (if desired). Also, several local computer stores typically offer workshop graduates discounts on purchases of related equipment, including new, larger monitors or additional RAM. Evidence of participation or equivalent discount coupons, accepted by several local computer stores, will be provided during the workshops upon request.

6. Student/parent/guardian hereby acknowledges that student is responsible for bringing sack lunches, beverages, and snacks. However, it is understood that workshop organizers may provide additional food/drinks/refreshments for the students. Therefore, any food allergies (e.g., milk, nuts, chocolate), religious or other dietary restrictions (e.g., low sugar) should be noted in the COMMENTS field of this form.

7. Student/parent/guardian stipulates that no medications will need to be administered to student during the workshops. Any special situations (arrangements for administering medication, including written permission with name of authorized provider, time, and dosage) should be noted in the COMMENTS field of this form. If at all possible, it is safest for all medications to be administered at home, before arrival; a qualified school nurse is NOT normally available during summer workshops. Any unique learning needs or disabilities that should be taken into consideration in working with this student (e.g., A.D.D., autism, hyperactivity) should also be noted in the COMMENTS field.

8. Student/parent/guardian grants permission for workshop organizers to obtain photographs of students participating in workshop activities, under carefully controlled conditions. Individual student pictures are to be used only for creating student (Classroom Technology Officer) identification cards, showing that student is a member of the CTO program. Group shots -- where students are not identified by name -- may also be used in promotional materials (such as can be seen on learningtech.org's web site), without compensation. Separate, written permissions shall always be sought in advance for any other usage of photographs depicting students. (Note: creating and editing photographs with a digital camera is one of the skills taught in some workshops.)

9. Student and parent/guardian agree that infractions of program rules (such as violating the school district's Appropriate Use Policy, including deliberately visiting inappropriate web sites, behaving disrespectfully in class, or exploiting passwords or CTO status for other than helpful reasons) is expected to result in relevant and appropriate consequences, up to and including removal from the program. In the case of the CTO program, minor infractions normally result in a corner being cut from the student's membership card. Major infractions, including loss of all card corners through multiple minor infractions, result in termination of membership and possibly other disciplinary measures. Parents may be called if necessary during class, in the rare case of serious behavior problems. Workshop graduates typically set the example at their schools for both skilled and appropriate technology usage. Program rules include arriving on time each day, and then returning to home or other scheduled activities upon completion of the session. Instructors are not available to provide before-class or after-hours day-care. If student has a partial overlap with another activity, apt to result in late arrival or a need for early departure, specifics should be noted in the COMMENTS field. Attendance is taken daily and parent/guardian will be contacted if a minor student has not arrived, about 30 minutes after starting time. Please call instructors in the event of absence such as for illness.

10. Cancellation and Refunds Policy: In the event that The Miller Institute needs to cancel one of our workshops, full refunds are given. If you withdraw from a class at least 3 working days before the class begins, then you will be issued a refund for tuition, less a $5 processing fee. However, a special policy applies to Parts Costs. Parts must be paid for 3 weeks prior to the first day of class. Parts will be ordered approximately two weeks prior to class. After we have ordered the parts, you own them, and no parts refund is possible, even if you then withdraw more than 3 days in advance. (If a part is defective, it will be exchanged for a working replacement part.)

11. Student/parent/guardian has been advised that a very limited number of scholarships are usually available each year, to help ensure that students are not excluded from participation due to financial hardship. Historically, service organizations such as Rotary, as well as private individuals, and The Miller Institute have worked together to sponsor scholarships for students in need. An authorized official from the child's school should notify workshop organizers that school records indicate financial need; no further details or other forms of documentation are necessary. Naturally, workshop organizers are unable to guarantee the availability of a scholarship, but in the past, sufficient philanthropic support has been identified to avoid excluding any applicant.

I have read the Workshop Permission Slip and I understand and agree to the terms and conditions for participating in these workshops.


_____________________________________________ (signature required when submitted in paper form)