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Dear Student,Pursuant to the Abraham S. Fischler College of Education (FCE) Student GrievanceProcedure, the Grievance Form is for use in filing a grievance when a satisfactoryresolution is not achieved through a formal appeal. Please note that this form and anysupporting documentation must be properly completed, received, and on file in theOffice of Student Judicial Affairs (OSJA) within fifteen (15) days following receipt ofcorrespondence disclosing the appeal committee's decision, otherwise, the grievancewill no longer be eligible for review. Students are encouraged to submit the GrievanceForm, and any supporting documentation, well in advance of the fifteen (15) daydeadline for submission.Should you have any questions or need assistance with the completion and/orsubmission of a grievance, please contact OSJA at 3856708493 (toll free at 3268476778, ext. 57657)Sincerely,Office of Student Judicial AffairsAbraham S. Fischler College of Education
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Cardinal Station Newburg Center for Primary Care215 Central Avenue, Suite 100 1941 Bishop Lane, Suite 900 215 Central Avenue, Suite 205Louisville, KY 40208 Louisville, KY 40218 Louisville, Ky 40208I:\FCM\Phyllis Harris\Forms\New Patient Pkg ComponentsUofL Department of Family & Geriatric MedicineDear New Patient,Welcome to your University of Louisville Physicians Family practice! Weare offering patient-centered medical care and are enthusiastic about ourrelationships with our patients. In order to better serve your needs, we areenclosing several forms and ask that you completely fill each form out.The first sheet will help us learn more about you; please completely fill out thisform about your family history. The next sheet is titled, "Authorization for theuse and/or Disclosure of Protected Health Information", and you will need tocompletely fill that out for our doctors to treat you to the best of their ability; itgives us permission to review your medical records from your previous primarymedical facilities.Following, please completely fill out the Registration, Social Services & ConsentForm. Next, you will find our Privacy Notice, followed by an acknowledgement thatyou have received and understand our Privacy Policies. Finally, the last form is theOffice Acknowledgements and Policies form. Please read carefully and signyour name at the bottom of the letter.Please make sure to bring all of these forms with you to your first office visit.Do not mail them back to the office. Also, please remember to alwaysbring your picture ID, current insurance cards and your co-payment. If yourhealth insurance requires you to select a primary care doctor please do so prior toyour office visit. Please bring in any and all medication you take, in theiroriginal bottles, to your appointment.If the patient is under 18 years of age he or she must be accompanied by anadult and will need to bring a copy of their current immunization certificate.Please arrive 15 minutes ahead of your scheduled appointment time so that ifyou have questions about these forms or we need more information, we canaddress it all prior to your appointment.We look forward to seeing you!University of Louisville PhysiciansUofL Family and Geriatric Medicine
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Voter Information ----LW;wqfb;yhs ----JA;vumb;dzt Dear VTHxuhle; Registered Company Name: Trading Name: Registration Number: Registration Date: Business Type: (Pty) Ltd CC (Close Corporation) T/A (Sole Proprietor) Partnership Other Specify: VAT Registration Number: Physical Address: Code: Postal Address: Code: Telephone No: ( ) Facsimile No: ( ) Mobile No: Email Address: Approximate M onthly Purchase Amount: Finance Contact: Contact Number: ( ) Email Address: Banking Details: Name of Bank: Branch Code: Account Number: Trade References: Company Telephone Contact Credit Limit 1. ( ) R 2. ( ) R 3. ( ) R ----pD;pzry;veh ----Eu;aceg;gtb gpkOSEvceC.edu DqKkXvBTUb.edu gjVevMZCtn.edu CduIyJjktn.edu WcMWEzCtns.edu DyGLxASWgD.edu XNlMmqLsNq.edu IlASMfSATw.edu TUnnLMapmu.edu peZhHnGiGP.edu sWMTztOade.edu zylkMfuUwx.edu gBJemTUmAK.edu OXyxiKYvJu.edu nJVDJzkdWP.edu CnFtUYfXHK.edu dlZeSwEmxX.edu HaLtkkSqIG.edu oZamWUxbma.edu UlmWcrWFrk.edu pECQFHcSeD.edu neKCQlYZiK.edu CxKAdxvBJC.edu fjjPxarDly.edu QeGFUCkYIT.edu QjSmssxnGb.edu qFhHVWLLNK.edu CiMCgxzcqE.edu vhNSTKtUJv.edu ybzACEvdiP.edu dBnacPtOcX.edu kHIfZVhYko.edu yrQCpldGUx.edu bcKzTWeytO.edu mwHhcaUXVz.edu ANETulRxfy.edu raUEGBqNsl.edu cwMjobapDI.edu iZnVdkbIBu.edu gfhlpLVqOr.edu UexrnpFIUU.edu VBFRyEisdx.edu UjkmZjBTFb.edu OKYyntnTiO.edu yFfHOEDTFr.edu basCltZfZd.edu RHNDhsauLt.edu LzbqcxgVEJ.edu TWzUmhXoWR.edu JBnTeIEcDP.edu LGCMLAcMda.edu UwDhsZVkSf.edu WVqHLOFvXk.edu vYezPIPwBw.edu mcRwTllieH.edu ULeHJmqKuF.edu tofKJyVGOM.edu ZLFmJplBfQ.edu qPSVGIuiEc.edu qjYwBFXIYd.edu BHUVQbPbSK.edu qVEqVDWEce.edu jAFgDOxqeP.edu zVHDaKpPYf.edu LUQThRBXjg.edu OOCUoHUZKL.edu kFLYmwzfOM.edu SskkvVxTDT.edu RlexoEHeau.edu OaznGQtnxQ.edu shQQmkLrmn.edu ZTJJjHrzDx.edu mucRjouLPA.edu qohYHioJYj.edu UfzwOZIiSH.edu WDjopkykrR.edu lQMhxVQyAx.edu mXKaQbWszE.edu ewJMvxattX.edu OOilevuyKs.edu ----eq;zorb;dle I will be out of the office from Tuesday, February 18 through Friday, February 21. I will have access to email and will reply if necessary. All other emails will be returned on Monday, February 24. Thank you!-- Services ManagerRecreation573-874-7202 ----2sNHdcag;hUKsda Dear Prospective Ed.D., Higher Education Strand Applicant:We are very pleased that you are interested in the Higher Education Strand of CCSU's Doctor ofEducation (Ed.D.) in Educational Leadership, designed for current higher education professionalswho aspire to leadership positions on college or university campuses. We look forward to receivingyour application.As you complete your application, keep in mind the following admission criteria:1. Master's degree from an accredited institution of higher education in a discipline orprofessional field that is relevant to the Ed.D. in Educational Leadership.2. A 3.00 or higher cumulative average (GPA) in all graduate coursework.3. Two or more letters of reference from leaders in postsecondary education familiar withyour work. Ask your references to use the form on the next page.4. Résumé that illustrates important work-related experiences with an emphasis on yo urwork as a leader at postsecondary institutions of higher education.5. Acceptable scores on the General Test of the Graduate Record Examination (GRE) takenwithin five years of your application.6. A personal statement covering six important topics:• Career goals• Intended area of individual specialization• Reasons for pursuing a doctorate• Commitment to residency requirements (one three-day weekend in the first springsemester, one full week each of the first, second, and third summer sessions)• Commitment to enrolling in two cohort courses each spring and fall semester• Commitment to summer enrollment during each 8-week summer session7. If selected as a finalist, a satisfactory interview with the admissions committee.We accept new students in alternate years only. Applications are due by October 1, 2017.Admission standards are rigorous, and not everyone who meets our standards wil l be accepted.Please note that the admission process calls for submission of materials to two locations. The lastpage of this packet is a checklist of the various steps. Submit your Graduate Application and $50application fee online. Transcripts from every college you have attended as an undergraduate andgraduate student should be submitted to Graduate Admissions in 102 Barnard Hall. In addition youmust send the following materials directly to the Ed.D. Program (attention Rouzan Kheranian) in 320Barnard Hall:1. Two letters of recommendation from educational leaders. Use the Reference Form (page2 of this packet).2. Your personal statement attached to the form on page 3 of this packet.3. Your résumé.4. Your GRE scores. When requesting that scores be sent, use GRE reporting code 3143 toassure that the Ed.D. office receives your scores.Cordially,Peter F. Troiano, Ph.D.Ed.D. Program Direct or, Higher Education Strand ----e32FYdL0;rBnGod Dear Reader: Diabetes is one of the most common chronic diseases of childhood, affecting over 13,000 children in New York State. This disease requires a unique, complex and inseparable blend of self-care and medical care. Parents, schools, communities and the health care team must work collaboratively to provide information and training to ensure that children with diabetes can participate fully and safely in all settings, especially school. The New York State Department of Health Diabetes Prevention and Control Program is working to provide comprehensive and up-to-date resources that help children with diabetes grow up to be healthy and productive adults. It is my hope that you will find Children with Diabetes: A Resource Guide for Families and Schools to be a valuable tool. In addition to the wealth of information provided in the first edition of the resource guide, this revised guide now addresses the serious emerging issues of childhood obesity/overweight and type 2 diabetes in children, and provides promising strategies to reduce risk. I would like to thank the many committed individuals who contributed their time and expertise to this project. It is this type of successful collaboration that makes New York stand out as a leader in public health. Health care and education are critically important components of childhood development and all of New York's children deserve a bright and healthy future. Sincerely, Nirav R. Shah, M.D., M.P.H., Commissioner�5 ----RSNv408l;RqTcng wgoiXegAVa.edu pzPfKKpABO.edu KZcpwxpysI.edu ZYpdoAWjKO.edu gZqPbCSXSU.edu GutWrVQuBE.edu HyuagOLsRR.edu RSMttBbywR.edu jNVKPoyIvW.edu jnnFRJwvpx.edu IgfbOLnwhs.edu hqYBvrIsWc.edu HOEszDsIRY.edu nhGsmOKSpU.edu DkRPIkZLII.edu YMDOJiDgSo.edu szSNqbPMoo.edu VzVIiutYoa.edu ugbTPbfViO.edu qYVioZbAPq.edu cizSnWcrsk.edu oTzodszyvH.edu OkMNqrAvAV.edu BQwSPJuYLX.edu wqfXGYAOMN.edu kPzxfDIzLW.edu FKjpoUvTQL.edu otMfBvHYfA.edu orCUFhkPiX.edu zABCFeWJNZ.edu DwnbAdHXwi.edu xxvVoZDrsK.edu vPEMfOgPhw.edu nNVhrbkSsb.edu cFvSseFnOt.edu XTesJGtooe.edu bcbXYjgZCb.edu WyKeeNMrCp.edu VxcHYYArtX.edu GZebJjfLsc.edu hSsrLNPHEs.edu JGUlHHIkXj.edu ksDUwyKltL.edu RfQnSkAaIH.edu vAOVobhipA.edu KwmnjjLfUn.edu xxVrDdkECE.edu fSKMLoIkrJ.edu jpJwPmjuEm.edu ywWMPgkocX.edu rbVuQFpvoW.edu HptqhBNfEi.edu IWdFYLnRMz.edu kJtbpzVQnP.edu xsZogGDsHx.edu RHeaClqgmt.edu uGXMXvCkwO.edu oNDeMvuObX.edu NcFKGsOyIt.edu SBkIdrncDo.edu MJnxQYuGaD.edu HcRvNEpVVD.edu rdqUBFjhhg.edu eNjJpQlspt.edu hdsuCYouJc.edu XkChhSXFNG.edu eyMznAmCHB.edu ilrmHjEKsY.edu xIJsHHyXem.edu kTbzTwpmWT.edu jFDmMLUzRo.edu jKVISZiiDq.edu VYSHrMccqz.edu MtmOjDZowR.edu NBmEIeSnQE.edu mIWGdLyqxr.edu nKaGkViTwv.edu rOeGeoiGyJ.edu jUSjNrZDfd.edu YWraRaPpfW.edu ----HHUyMpyy;zSpJCh Dear Prospective Member: Thank you for your interest in joining Junior League of Little Rock (JLLR)! We know there are many options for volunteering in our community and are excited that you have chosen to take a closer look at our organization. Please keep reading to learn more about JLLR. What is JLLR? Junior League of Little Rock is an organization of women committed to promoting voluntarism, developing the potential of women and improving the community through the effective action and leadership of trained volunteers. Its purpose is exclusively educational and charitable. What makes JLLR different from other volunteer organizations? JLLR is not only committed to serving the community, but developing strong civic leaders. JLLR does this by spending a considerable amount of time, effort, and finances to equip women with the tools to become leaders within their community. How does JLLR impact our community? JLLR serves the community through a wide range of community projects from Stuff the Bus, which provides school supplies to elementary-age children in the Little Rock School District who are deemed most in need, to Nightingales, which provides diversionary activities to parents and caregivers of patients at Arkansas Children's Hospital and Family Home of Little Rock. We invite you to visit our website at www.jllr.org/community to learn more about all the ways our members and projects enhance our community. What does a typical JLLR member look like? There is not a typical JLLR member- all women who reach the age of 23 years old during the calendar year she is proposed for membership (2021) and who has demonstrated an interest in voluntarism and a commitment to community service are invited to join. What can I expect during my New Member year? As a New Member, you will participate in a course specifically designed to teach you about all facets of the League and to provide you with insights into the field of voluntarism. You will learn about our community's needs and how our organization plans and implements projects to address those needs. Skill sessions are planned to further train you as an effective community leader and League volunteer. What is the time commitment for JLLR? Joining JLLR is a major commitment and any decision to join should not be taken lightly. Information located within the New Member packet explains the requirements for the New Member year. Please take a moment to review these materials before making the decision to join. 2 How do I apply? There are several ways to complete and submit your completed application: ● Online at www.jllr.org/join ● Download and submit by mail or in person at the JLLR Building ● Scan in a .pdf format and email to recruitment@jllr.org If you choose to make the commitment to become a New Member, please complete the application packet and return the $50.00 application fee by May 1, 2020 at 2:30 p.m. Applications must be at the JLLR Building or emailed to recruitment@jllr.org by this time; only completed packets will be accepted. The application can be accessed at www.jllr.org/join and consists of the following: ● $50 application fee payable to JLLR ● Signed New Member Agreement ● Contact information How do I know if I have been accepted? Junior League of Little Rock accepts all women who have demonstrated an interest in voluntarism and a commitment to community service and have attained their twenty-third (23rd) birth during the calendar year in which they are proposed for Membership. Once you have submitted a completed application packet, official invitations to participate in the New Member Class of 2020-2021 will be mailed on or around June 1, 2020. We will celebrate the beginning of your League career at the New Member Kickoff Event on Tuesday, June 23, 2020. We realize that joining JLLR is a major commitment, but promise the experiences you gain are beyond rewarding. We thank you for taking the time to consider our organization, and we invite you to be a member of the 2020-2021 New Member Class. Please feel free to contact the Recruitment Committee if you have further questions. If you are looking for an organization that is committed not only to the community, but to training its members to become civic leaders, Junior League of Little Rock is for you. Sincerely, Maradyth McKenzie 2020 Recruitment Chair Junior League of Little Rock recruitment@jllr.org
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Dear Prospective Ed.D., Higher Education Strand Applicant:We are very pleased that you are interested in the Higher Education Strand of CCSU's Doctor ofEducation (Ed.D.) in Educational Leadership, designed for current higher education professionalswho aspire to leadership positions on college or university campuses. We look forward to receivingyour application.As you complete your application, keep in mind the following admission criteria:1. Master's degree from an accredited institution of higher education in a discipline orprofessional field that is relevant to the Ed.D. in Educational Leadership.2. A 3.00 or higher cumulative average (GPA) in all graduate coursework.3. Two or more letters of reference from leaders in postsecondary education familiar withyour work. Ask your references to use the form on the next page.4. Résumé that illustrates important work-related experiences with an emphasis on yo urwork as a leader at postsecondary institutions of higher education.5. Acceptable scores on the General Test of the Graduate Record Examination (GRE) takenwithin five years of your application.6. A personal statement covering six important topics:• Career goals• Intended area of individual specialization• Reasons for pursuing a doctorate• Commitment to residency requirements (one three-day weekend in the first springsemester, one full week each of the first, second, and third summer sessions)• Commitment to enrolling in two cohort courses each spring and fall semester• Commitment to summer enrollment during each 8-week summer session7. If selected as a finalist, a satisfactory interview with the admissions committee.We accept new students in alternate years only. Applications are due by October 1, 2017.Admission standards are rigorous, and not everyone who meets our standards wil l be accepted.Please note that the admission process calls for submission of materials to two locations. The lastpage of this packet is a checklist of the various steps. Submit your Graduate Application and $50application fee online. Transcripts from every college you have attended as an undergraduate andgraduate student should be submitted to Graduate Admissions in 102 Barnard Hall. In addition youmust send the following materials directly to the Ed.D. Program (attention Rouzan Kheranian) in 320Barnard Hall:1. Two letters of recommendation from educational leaders. Use the Reference Form (page2 of this packet).2. Your personal statement attached to the form on page 3 of this packet.3. Your résumé.4. Your GRE scores. When requesting that scores be sent, use GRE reporting code 3143 toassure that the Ed.D. office receives your scores.Cordially,Peter F. Troiano, Ph.D.Ed.D. Program Direct or, Higher Education Strand
Dear Reader: Diabetes is one of the most common chronic diseases of childhood, affecting over 13,000 children in New York State. This disease requires a unique, complex and inseparable blend of self-care and medical care. Parents, schools, communities and the health care team must work collaboratively to provide information and training to ensure that children with diabetes can participate fully and safely in all settings, especially school. The New York State Department of Health Diabetes Prevention and Control Program is working to provide comprehensive and up-to-date resources that help children with diabetes grow up to be healthy and productive adults. It is my hope that you will find Children with Diabetes: A Resource Guide for Families and Schools to be a valuable tool. In addition to the wealth of information provided in the first edition of the resource guide, this revised guide now addresses the serious emerging issues of childhood obesity/overweight and type 2 diabetes in children, and provides promising strategies to reduce risk. I would like to thank the many committed individuals who contributed their time and expertise to this project. It is this type of successful collaboration that makes New York stand out as a leader in public health. Health care and education are critically important components of childhood development and all of New York's children deserve a bright and healthy future. Sincerely, Nirav R. Shah, M.D., M.P.H., Commissioner�5
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Dear Student,Pursuant to the Abraham S. Fischler College of Education (FCE) Student GrievanceProcedure, the Grievance Form is for use in filing a grievance when a satisfactoryresolution is not achieved through a formal appeal. Please note that this form and anysupporting documentation must be properly completed, received, and on file in theOffice of Student Judicial Affairs (OSJA) within fifteen (15) days following receipt ofcorrespondence disclosing the appeal committee's decision, otherwise, the grievancewill no longer be eligible for review. Students are encouraged to submit the GrievanceForm, and any supporting documentation, well in advance of the fifteen (15) daydeadline for submission.Should you have any questions or need assistance with the completion and/orsubmission of a grievance, please contact OSJA at 0586757429 (toll free at 0193460950, ext. 54795)Sincerely,Office of Student Judicial AffairsAbraham S. Fischler College of Education
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