DLI Training Course 2026-2027

1 School Information

Please complete the fields below

School Name *

School Address *

City *

State / Province *

Zip *

School Phone Number *

Principal Title

Principal First Name *

Principal Last Name *

Principal Extension Number

Principal Cell Phone Number

Principal Email Address *

What is the population of the registering school?

Total number of students in the school(s):

Grades served:

Number of parallel classes per grade:

Have any faculty members attended the DLI Training in the past?

Yes No

Does the school have an on-site resource room?

Yes No

2 Participant Information

Please fill out the information below for the course applicant. This form may be completed by the applicant or by a school representative.

Title *

First Name *

Last Name *

Email Address *

Cell Phone Number *

Can the participant receive SMS text messages at this number?

Yes No

Participant’s Home Address

Street Address

City

State / Province

Postal / Zip Code

Occupation Information

Please complete the fields below to provide information on the participant’s background and current occupation.

Participant’s position in the school

Participant’s roles and responsibilities

Qualifications and areas of strength

Educational Background

Other PD opportunities the participant has taken part in (courses, workshops, etc.)

What the participant hopes to gain from the DLI training

3 Payment Structure

$2,200 per person · Contact us for group rates.

Please note: Total price includes a 10% non-refundable registration fee.

Credit Card Information

We accept all major credit cards as well as OJC Fund, Donors Fund, and Pledger charity cards — enter the charity card number just like a credit card.

Name on card *

Card number *

Expiration (MM/YY) *

CVV *

Billing address *

City *

State *

Zip *

🔒 Payments are processed securely by Banquest. Card details are never stored on our servers.

I understand that course fees are non-refundable after course start date.

The DLI Training Course

Registration Opens Soon

1 School Information

Former Trainee Information

Resource Room Information

2 Participant Information

Participant’s Home Address

Occupation Information

3 Payment Structure

Credit Card Information

Thank you for registering!