national garden clubs, inc. course roster & environmental ... · to complete form, download and...
TRANSCRIPT
To complete form, download and save to your device, add your information, then save again.
Schools Course Roster & Summary 5-2020 1 Revised April 2020
State School Chairman: • Send one hard copy of this Course Roster & Summary (Form5-2020), upon receiving approval of respective
Accrediting Chairman, along with check payable to NGC, Inc. to: NGC Schools’ Secretary, NGC Headquarters,4401 Magnolia Avenue, St. Louis, MO 63110-3406.
• Send one electronic copy of this Course Roster & Summary (Form5-2020) to the ES, GS or LDS AccreditingChairman for your region along with a scanned copy of the check sent to NGC Headquarters.
• 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:
To complete form, download and save to your device, add your information, then save again.
Schools Course Roster & Summary 5-2020 2 Revised April 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 #
To complete form, download and save to your device, add your information, then save again.
Schools Course Roster & Summary 5-2020 3 Revised April 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 #
To complete form, download and save to your device, add your information, then save again.
Schools Course Roster & Summary 5-2020 4 Revised April 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 April 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 #
To complete form, download and save to your device, add your information, then save again.
Schools Course Roster & Summary 5-2020 6 Revised April 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 #