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Schools Course Roster & Summary 5-2020 1 Revised Aug 2020

State School Chairman: • Send one electronic copy of this Course Roster & Summary (Form5-2020) to the ES, GS or LDS Accrediting

Chairman for your region.• Mail student/consultant fee check to Accrediting Chairman, who will send check to Schools Secretary upon

approval of information on Course Roster & Summary.• Include fees of $5.00 for each attendee seeking credit as a student or a refresher as calculated below.*• Keep a signed copy for your state records.

Check appropriate School: Environmental School Gardening School Landscape Design School Course # Series # or Single-SubjectRefresher Title City/State Date(s) State Garden Club Region Local Chairman Phone Email Completed & Submitted by Date to State School Chairman

Local School/Event Chairman State School Chairman Email Address Phone City/State/Zip Code

Attendance Summary:

*Make check payable to NGC for this amount and send as indicated above. Date Sent Check #

IMPORTANT! List Students and Refreshers alphabetically by last name, first name. Check only one: (CR) for students taking course for credit OR (R) for refreshing Consultants . Check (M) for a NGC Garden Club Member or (NM) for a non-member of NGC. Check other boxes as appropriate for each attendee.

National Garden Clubs, Inc. Environmental, Gardening and Landscape Design Schools

COURSE ROSTER & SUMMARY

Course Roster & Summary

Form 5-2020

NGC Member Students # Registered # Taking Exam

@$5 each # Passed # Failed

Non-NGC Members # Registered # Taking Exam @$5 each # Passed # Failed

Subtotal # Registered # Taking Exam @$5 each # Passed # Failed

NGC Consultants # Registered # Taking for Credit @ $5 each

TOTAL # Registered # Taking Exam or for Credit @ $5 each Total* $

1 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 2 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher:

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Schools Course Roster & Summary 5-2020 2 Revised Aug 2020

State Chairman Date

Approved by Date NGC ES/GS/LDS Accrediting Chairman

3 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 4 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 5 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 6 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 7 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 8 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 9 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 10 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 11 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 12 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 13 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher:

Course # Series #

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Schools Course Roster & Summary 5-2020 3 Revised Aug 2020

State Chairman Date

Approved by Date NGC ES/GS/LDS Accrediting Chairman

14 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 15 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 16 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 17 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 18 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 19 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 20 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 21 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 22 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 23 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 24 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher:

Course # Series #

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Schools Course Roster & Summary 5-2020 4 Revised Aug 2020

State Chairman Date

Approved by Date NGC ES/GS/LDS Accrediting Chairman

25 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 26 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 27 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 28 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 29 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 30 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 31 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 32 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 33 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 34 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 35 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher:

Course # Series #

To complete form, download and save to your device, add your information, then save again.

Schools Course Roster & Summary 5-2020 5 Revised Aug 2020

State Chairman Date

Approved by Date NGC ES/GS/LDS Accrediting Chairman

36 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 37 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 38 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 39 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 40 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 41 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 42 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 43 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 44 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 45 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 46 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher:

Course # Series #

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Schools Course Roster & Summary 5-2020 6 Revised Aug 2020

State Chairman Date

Approved by Date NGC ES/GS/LDS Accrediting Chairman

47 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 48 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 49 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 50 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 51 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 52 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 53 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 54 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 55 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 56 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher: 57 CR R M NM Name Email Phone

Address Garden Club

Students: Pass Fail # of courses previously passed Check one: Consultant Master Consultant Date of last course/refresher:

Course # Series #