Kildeer Countryside School District 96
PLC Visitation Registration Form
Your reservation cannot be processed or confirmed without the submission of this form.
Make a check payable to Kildeer Countryside School District 96 (Purchase orders and credit cards will not be accepted.)
Attn: Melissa Mark, 1050 Ivy Hall Lane, Buffalo Grove, IL. 60089
Payment is due one week prior to the date of visit.
Do not make airfare or hotel reservations before receiving written confirmation of your scheduled data of visit and number of participants.
Name of visiting school and district
*
Visiting school or district address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Visiting contact person
*
First Name
Last Name
Visiting contact phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Visitor contact email
*
example@example.com
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Site visit date requested for the 2025-2026 school year
*
Please Select
Monday, March 9, 2026 (ELEM CLOSED)
Thursday, April 16, 2026 (ELEM CLOSED)
Check One:
*
Elementary School Presentation
Middle School Presentation
Both Elementary and Middle School Presentations
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Number of elementary school visitors
*
Number of middle school visitors
*
Total number of visitors
Total payment amount
Flat Rate: $500 for the first 10 visitors. Additional visitors beyond 10: $50 per person.
What PLC concept(s) would you like to make the focus of this visit?
*
A confirmation email and invoice will be sent after your registration is reviewed.
Submit
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