Certified Facilitator Order Form

Certified Facilitator Order Form

Please be sure to submit this form a minimum of three weeks ahead of your online course start date. Please submit a new form for each cohort you will be facilitating.
Certified Facilitator Information
Certified Facilitator Name*

First NameLast Name
Certified Facilitator Email*

Confirmation Email
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Sponsoring Education Organization*
Please list your sponsoring organization (e.g., ESC, BOCES, RESA, IU, CESA, SST, School District, School Name)
Co-Certified Facilitator Name(s) (If applicable)
Cohort information

Please provide the following information for your cohort:
District/School Being Trained*
IT Department Contact*

First NameLast Name
IT Department Contact Email*
example@example.com
Online Course Start Date

The recommended start date is one day before the first facilitated session. Participants will receive access to the online course on the date you choose.
Online Course Start Date*

MonthDayYear
Must be minimum 3 weeks from submission of form
Materials Needed:

Please note: You must be certified in the topic you wish to order materials for. Orders placed for other topics you are not certified to facilitate will not be processed. Only one topic can be ordered at a time. You can use the same purchase order for multiple orders. Please attach it for each.
Please select the topic you are facilitating and the quantity of licenses/manuals you will require. *
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Keys to Beginning Reading
Registration fee for Keys to Beginning Reading CF training (includes online course, training book, and shipping)

$350.00 Quantity
Item subtotal:$0.00



Key Comprehension Routine
Registration fee for The Key Comprehension Routine CF training (includes online course, training book, and shipping)

$210.00 Quantity
Item subtotal:$0.00



Key Vocabulary Routine
Registration fee for The Key Vocabulary Routine CF training (includes online course, training book, and shipping)

$210.00 Quantity
Item subtotal:$0.00



Keys to Content Writing
Registration fee for Keys to Content Writing CF training (includes online course, training book, and shipping)

$210.00 Quantity
Item subtotal:$0.00



Keys to Early Writing
Registration fee for Keys to Early Writing CF training (includes online course, training book, and shipping)

$210.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy - All Modules
Registration fee for The Keys to Adolescent Literacy CF training (includes online course, training book, and shipping)

$350.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy - Module 1: Introduction/Literacy Basics
Registration fee for The Keys to Adolescent Literacy Module 1: Introduction/ Literacy Basics CF training (includes online course. BOOK NOT INCLUDED. please order book below)

$49.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy - Module 2: What is Adolescent Literacy?
Registration fee for The Keys to Adolescent Literacy - Module 2: What is Adolescent Literacy? CF training (includes online course. BOOKS NOT INCLUDED. please order book below)

$49.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy - Module 3: Vocabulary Instruction
Registration fee for The Keys to Adolescent Literacy Module 3: Vocabulary Instruction CF training (includes online course. BOOKS NOT INCLUDED. please order book below)

$69.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy - Module 4: Comprehension Instruction
Registration fee for The Keys to Adolescent Literacy Module 4: Comprehension Instruction CF training (includes online course. BOOK NOT INCLUDED. please order book below)

$69.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy - Module 5: Teaching Text Structure
Registration fee for The Keys to Adolescent Literacy Module 5: Teaching Text Structure CF training (includes online course. BOOK NOT INCLUDED. please order book below)

$49.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy - Module 6: Writing Instruction
Registration fee for The Keys to Adolescent Literacy Module 6: Writing Instruction CF training (includes online course. BOOK NOT INCLUDED. please order book below)

$49.00 Quantity



Keys to Adolescent Literacy - Module 7: Supporting Learning Through Discussion
Registration fee for The Keys to Adolescent Literacy Module 7: Supporting Learning Through Discussion CF training (includes online course. BOOK NOT INCLUDED. please order book below)

$49.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy - Module 8: Advanced Word Study & Fluency
Registration fee for The Keys to Adolescent Literacy Module 8: Advanced Word Study & Fluency CF training (includes online course. BOOK NOT INCLUDED. please order book below)

$49.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy - Module 9: Integrating Literacy into Content Instruction
Registration fee for The Keys to Adolescent Literacy Module 9: Integrating Literacy into Content Instruction CF training (includes online course. BOOK NOT INCLUDED. please order book below)

$49.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy - Module 10: Adolescent Learners with Literacy Difficulties
Registration fee for The Keys to Adolescent Literacy Module 10: Adolescent Learners with Literacy Difficulties CF training (includes online course. BOOK NOT INCLUDED. please order book below)

$49.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy - Module 11: Data-Driven Reading Instruction/ Wrap-Up
Registration fee for The Keys to Adolescent Literacy Module 11: Data-Driven Reading Instruction/ Wrap-Up CF training (includes online course. BOOK NOT INCLUDED. please order book below)

$49.00 Quantity
Item subtotal:$0.00



Keys to Adolescent Literacy Book
Keys to Adolescent Literacy Book ONLY (Online course not included)

$39.95 Quantity
Item subtotal:$0.00



Total

$0.00
Participant Information

Participant Names and emails will be needed. See example below.
Please download this Participant Information Sheet template to use to add participant information for your cohort.

For Shipping:

If you need to ship manuals to your individual participants, please add their addresses in your Participant Information Sheet. Please note, shipping to individual addresses may incur additional costs.

For shipping all materials to one address, please add the shipping address in the section below rather than on the Participant Information sheet.
Please upload participant list here.

For edits to your list, please contact sarah.byrne@keystoliteracy.com
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Shipping and Billing Information

For questions contact sarah.byrne@keystoliteracy.com
Payment Information

Please upload your purchase order below or mail checks to: Keys to Literacy 319 Newburyport Turnpike Suite 205 Rowley, MA 01969. If you need to submit your purchase order at a later date, please email it to sarah.byrne@keystoliteracy.com as soon as possible. We are unable to ship materials or enroll participants into the online course until a payment is received.
Please upload purchase order here

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Yes! Please ship as soon as possible.No, please ship closer to training date. (typically arrives 1 week prior)
Shipping Address (all manuals must be shipped to one address)*

Street Address

Street Address Line 2

CityState

Zip Code
Billing Address (Skip if same as shipping)

Street Address

Street Address Line 2

CityState

Zip Code
Should be Empty:

Certified Facilitator Order Form

Certified Facilitator Information

Cohort information

Online Course Start Date

Materials Needed:

Participant Information

Shipping and Billing Information

Payment Information