PaCE

Professional andContinuing Educationwww.bhc.edu

presents:

Lifelong Learner Program(Formerly Golden Scholars/Golden Opportunities)

Especially designed for anyone celebrating years of 55 or better,but all learners are welcome!

For more information, please call 309-796-8223.

August - December 2014

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Lifelong Learner LunchesIn cooperation with the QC Times Plus 60 Club.

All programs are offered at handicap accessiblevenues with ample free parking available. Early registration is encouraged.

A Look at Sherman’s MarchPresenter: Dr. Arthur PitzIn the midst of the 150th anniversary of the U.S. Civil War, well-known local historian and professor Dr. Arthur Pitz takes a look atthe capture of Atlanta followed by Sherman’s controversial Marchto the Sea in the fall of 1864. What impact did this bold move haveon the outcome of the war? What were the results? Join us forlunch at The Lodge and an enticing look at some of the lesserknown history of our country.Date: Wednesday, Sept. 17Location: The Lodge

I-74 and Spruce Hills Drive, Bettendorf, IALunch: 11:30 a.m.Presentation: 12:15 p.m.Fee: $22Refunds: Available until Sept. 10CRN: 81978

Quad City International Airport -Through the YearsPresenters: Cathie Rochau and Dave CoopmanIn 1910, a Rock River valley pasture known as Franing Field wasselected for the first coast-to-coast flight by U.S. Army planes.Since that time, numerous changes have led to what is now theQuad City International Airport, resulting in a significant impacton the travel industry in the area. Join QCIA marketing directorCathie Rochau and local historian Dave Coopman as we take alook at the airport then and now.Date: Wednesday, Oct. 15Location: Quad City International Airport, MolineLunch: 11:30 a.m.Presentation: 12:15 p.m.Fee: $22Refunds: Available until Oct. 8CRN: 81979

What’s So Funny About the Radio?Presenter: Bill HannanFrom Jack Benny to Amos ‘n’ Andy, radio was the source of muchlaughter during the time commonly known as the Golden Age ofRadio. Professor emeritus Bill Hannan takes us on an entertainingjourney back through the popular network comedy shows of the1940s and 1950s.Date: Wednesday, Nov. 19Location: Johnny’s Metro, MolineLunch: 11:30 a.m.Presentation: 12:15 p.m.Fee: $22Refunds: Available until Nov. 12CRN: 81980

Sounds of the SeasonPresenter: Davenport Central High SchoolOur ever-popular traditional holiday event returns again to kickoff the season. Join us at the beautifully decorated Abbey Stationto hear an engaging live performance of holiday music by theDavenport Central High School carolers. With two dates tochoose from, don’t miss the opportunity to continue this populartradition. Seasonal door prizes will also be given away.Date: Tuesday, Dec. 2 or

Friday, Dec. 5Location: The Abbey Station

3031 5th Ave., Rock Island, ILLunch: 11:30 a.m.Presentation: 12:15 p.m.Fee: $22Refunds: Available until Nov. 25CRN: 81981 (December 2)

81982 (December 5)

Lifelong Learner LunchesEspecially designed for anyone celebrating years of 55 or better, but all learners are welcome!

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Lifelong LearnerProgram

Arts & Crafts

Watercolor Painting Fall ColorsInstructor: P. GrommExplore mixing earth tones to create intense vibrant colors foryour impact area and muting the same mix to make value changesfor depth in your landscapes. Bring a tablet of 140 lb. cold press watercolor paper, a #2 school pencil, a kneadederaser and a #8 round watercolor paintbrush. List of nine basiccolors of paints will be given at the first class.4 Mondays Sept. 15 - Oct. 6 9:00 - 11:00 a.m.CRN 81941 Outreach - Rm. 204 Fee $38

Watercolor Painting Reflections inWater Instructor: P. GrommThis class will be helpful for both beginning and advanced stu-dents. We will be painting the 10 rules for showing reflections inwater. These paintings will be not much more than thumbnailstudies. Bring a tablet of 140 lb. cold press watercolor paper(about 9" x 12"), a #2 school pencil, a kneaded eraser and a #8round watercolor paintbrush. Limited paint list will be given atthe first class. 4 Mondays Sept. 15 - Oct. 6 Noon - 2:00 p.m.CRN 81942 Outreach - Rm. 204 Fee $38

Drawing Your Pet in Colored PencilInstructor: P. GrommBy the use of a grid, you can draw a good likeness of your pet.Then it will be only a matter of seeing values and colors and whatto do with the background. Bring a photo(s) no larger than 8" x10" of your pet, a #2 school pencil, an eraser and a sketchbook tothe first class. A list of colored pencils will be given at that time.4 Tuesdays Sept. 16 - Oct. 7 9:00 - 11:00 a.m.CRN 81943 Outreach - Rm. 204 Fee $38

Graphite Drawing of BarnsInstructor: P. GrommThe old weathered barns are always popular and a good subjectfor drawings and paintings. You will work from up-close photosof barns to help see those subtle changes in values which createthe old wood textures. Bring to first class HB, 2B and 4B pencils,an eraser and a drawing paper/sketch book (about 9" x 12").4 Tuesdays Sept. 16 - Oct. 7 Noon - 2:00 p.m.CRN 81944 Outreach - Rm. 204 Fee $38

Anyone Can Learn to Draw, Part 1Instructor: P. GrommLearn to move away from flat on the surface sketches to three-dimensional into the surface sketches. There are seven basic rulesto follow. Bring to the first class a sketchpad (about 9" x 12"), 2Band 4B drawing pencils, and an eraser.4 Thursdays Oct. 2 - Oct. 23 9:00 - 11:00 a.m.CRN81945 Outreach - Rm. 204 Fee $38

Anyone Can Learn to Draw, Part 2Instructor: P. GrommYou are welcome even if you did not take Part 1. We will reviewthe seven basic rules of drawing while drawing a still life, land-scape and self-portrait. Bring to the first class a sketchpad, 2B and4B drawing pencils, and an eraser.4 Thursdays Oct. 23 - Nov. 20 Noon - 2:00 p.m.CRN 81946 Outreach - Rm. 204 Fee $38(No class Oct. 30)

Watercolor CrystalInstructor: P. GrommLight through crystal and glass can be so beautiful, and nothingbrings out that beauty as well as transparent watercolor. Photosfor reference, step-by-step instruction sheets and the instructor’sdemonstrations all should show you how to observe and paintlight, establish values, mingle saturated colors, glazing and more.Bring a tablet of 140 lb. cold press watercolor paper, a #2 schoolpencil, a kneaded eraser and a #8 round watercolor paintbrush.List of nine basic colors of paints will be given at the first class.4 Mondays Nov. 3 - Nov. 24 9:00 - 11:00 a.m.CRN 81947 Outreach - Rm. 204 Fee $38

Watercolor PencilInstructor: P. GrommYou may have tried watercolor or colored pencils, and now youare curious as to how watercolor pencils compare. Watercolorpencils allow you both the fluidity of watercolor and the control ofcolored pencil, plus they are easy to transport. This class willwork through step-by-step lessons to learn a wide range of tech-niques using only a beginning set of 12 watercolor pencils. Bringa small tablet of Bristol Board paper, a #2 school pencil and a #6round watercolor paint brush. If you have watercolor pencils,bring them along to the first class.4 Mondays Nov. 3 - Nov. 24 Noon - 2:00 p.m.CRN 81948 Outreach - Rm. 204 Fee $38

New

New

Instructor Phyllis Gromm

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Photography

Digital Photography for the BeginnerInstructor: L. VanHeseFirst time with a digital camera? Perhaps you received a newcamera as a gift and have no idea what to do with it? Come learnthe basics of digital photography, practice in class, and increaseyour familiarity and comfort level with your camera. Please bringyour camera, charged batteries, USB cable, owner’s manual anda flash drive to class.4 Tuesdays Sept. 9 - Sept. 30 9:00 - 11:00 a.m.CRN 81949 Outreach - Rm. 402 Fee $42

Develop Your Beginning DigitalPhotography SkillsInstructor: L. VanHeseIf you’ve mastered the basics of your digital camera, this hands-on class will help you develop skills to bring out the best in yourdigital images. Designed to give you confidence with your digitalcamera, class time will introduce you to the elements of composi-tion and image editing software. Please bring your camera,charged batteries, USB cable, owner’s manual and a flash driveto class.4 Tuesdays Oct. 7 - Oct. 28 9:00 - 11:00 a.m.CRN 81950 Outreach - Rm. 402 Fee $42

On the Web

Social Media for BeginnersInstructor: K. WoodwardDo the words Facebook, Pinterest, Instagram and Foursquaremean anything to you? What about WordPress, YouTube, Twitter,LinkedIn or Google Plus? If you feel overwhelmed and confusedby the number of social media sites out there, this class is for you.You'll be introduced to the top social media sites and learn whento use them, how to set up profiles and best practices to makeusing social media safe and fun. 1 Wednesday Sept. 10 9:30 - 11:30 a.m.CRN 81962 Outreach - Rm. 204 Fee $18

Blogging for BeginnersInstructor: K. WoodwardDo you have passion or expertise? A blog can help you share itwhile staying connected with friends and family members,meeting like-minded people, and providing you with a creativeoutlet. Learn the basics of blogging and set up your own blog withthe help of an experienced lifestyle blogger. This class is for truebeginners without a blog. Topics include setting up a blog andcustomizing it, developing a blog plan, generating content ideasand increasing readership. At the end of the two-week session,you will walk away with a plan and a functioning blog to shareyour passion with the world.2 Tuesdays Sept. 23 - Sept. 30 1:00 - 3:00 p.m.CRN 81964 Outreach - Rm. 406 Fee $28

Genealogy

Memories Past: Discovering YourAncestors on the InternetInstructor: P. ChaseJoin us as we hunt for your ancestors. You will learn to trackdown genealogical clues that will further expand your knowledgeof your ancestors and their lives. Learn the value of using Internetsearch engines in locating tips to establish where your ancestorslived. You will learn to use Internet websites that will allow youto trace immigrant ancestors. Discover websites that may haveinformation pertaining to subjects that range from discoveringyour great-grandfather’s date of birth to your grandparents’ dateof death. Come explore your family connections and remember tobring along your pedigree chart and family group sheet for thefamily you are focusing on. 4 Thursdays Sept. 11 - Oct. 2 12:30 - 2:30 p.m.CRN 81966 Outreach - Rm. 405 Fee $38

Computers

Getting Started with Your Computer Instructor: N. VanSpeybroeckLevel 0 - If you own a computer or are considering purchasingone, this class will provide you with some beginner basics. You will learn basic terminology, hardware vs. softwareand the components of a computer. You will turn on and shutdown the computer, learn about various storage devices andmedia, as well as practice operating the mouse. Become familiarwith the keyboard and get acquainted with the Windows con-cept. You will use the Start menu, open a program, create yourown poster and print it to take home.Windows 8.12 Mondays Sept. 8 - Sept. 15 12:30 - 2:30 p.m. CRN 81865 Outreach - Rm. 405 Fee $30

Windows 72 Mondays Oct. 20 - Oct. 27 8:30 - 10:30 a.m.CRN 81866 BHC ALC - Rm. 112 Fee $30

Getting Started with WindowsInstructor: N. VanSpeybroeckPrerequisite: Getting Started with Your Computer or equivalentexperienceLevel 0 – Learn basic Microsoft Windows skills including how toidentify parts of a window and how to manipulate windows andthe taskbar. Learn how to see how much space you have availableon your hard drive. You will use menus, Help and Support, thecalculator, save to a CD and flash drive, open a basic word pro-cessing program (WordPad), create a letter, print it and save thefile. A reference guide is included in the fee. You may wish tobring a USB flash drive to the second session of class.Windows 8.12 Mondays Sept. 22 - Sept. 29 12:30 - 2:30 p.m.CRN 81867 Outreach - Rm. 405 Fee $30

Windows 72 Mondays Nov. 3 - Nov. 10 8:30 - 10:30 a.m.CRN 81868 BHC ALC - Rm. 112 Fee $30

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Cleaning Up Your ComputerInstructor: N. VanSpeybroeckLevel 1 – You know how to use your computer but how do youmaintain it to keep it running? Have you crashed your computer?Or perhaps have been on the Internet and stored many temp files?This class will teach you how to keep your computer up and run-ning by defragging, cleaning up temporary Internet files andcookies, checking your disk space and more.1 Monday Dec. 1 8:30 - 10:30 a.m.CRN 81871 BHC ALC - Rm. 112 Fee $21

Organizing Your Files & Folders Instructor: N. VanSpeybroeckPrerequisite: Basic Windows or equivalent experienceLevel 1 – If you know the basics of Windows 7 and are eager tolearn more, this session will expand your Windows 7 knowledge.Organize your computer files by creating folders, moving andcopying files into folders and creating shortcuts.1 Monday Oct. 6 10:45 a.m. - 12:45 p.m.CRN 81872 Outreach - Rm. 402 Fee $21

Learning How to Use Word ProcessingInstructor: N. VanSpeybroeckLevel 1 – Word processing is using a computer to create, edit andprint documents. Learn how to produce letters, family stories,newsletters, memoirs and minutes for meetings. Be creative andproduce great-looking documents. You will learn to edit, changefonts, use the ribbon, tabs, bullets, tables, letters/envelopes, spellcheck, cut, copy, paste and more. 3 Mondays Oct. 20 - Nov. 3 10:45 a.m. - 12:45 p.m.CRN 81873 BHC ALC - Rm. 112 Fee $42

Holiday MailingInstructor: N. VanSpeybroeckPrerequisite: Learning How to Use Word Processing or equiva-lent experienceLevel 2 – Learn how to create form letters, labels and envelopes tosend mailings to all of your family and friends using MicrosoftWord’s mail merge feature. You can use the skills you will gain inthis class to send holiday mailings, reunion mailings and more.You may bring your handwritten or computerized address book tocreate a database. Also bring a USB flash drive to save your files.2 Mondays Nov. 10 - Nov. 17 10:45 a.m. - 12:45 p.m.CRN 81874 BHC ALC - Rm. 112 Fee $30

Emailing BasicsInstructor: N. VanSpeybroeckLevel 1 – Whether you would just like to learn what email is orif you are interested in exploring the idea for your home com-puter, this class is a basic session on emailing. We will coverunderstanding email addresses, how to send, save and forwardmessages and more. If you have an email account, please bringto class your email address and password to access your webmail.1 Monday Dec. 1 10:45 a.m. - 12:45 p.m.CRN 81875 BHC ALC - Rm. 112 Fee $21

Sharing Photos OnlineInstructor: N. VanSpeybroeckLevel 2 – Learn a new way to share your photos with friends andfamily. Learn to use Shutterfly, a free online photo service, toarrange your digital pictures into online albums. Learn how tosend email invitations to your friends and family so they caneasily view your photos as a slideshow without having to down-load each individual picture. Also, learn to rotate, crop, add bor-ders, fix red-eye and more.1 Monday Sept. 29 9:30 - 11:30 a.m.CRN 81876 Outreach - Rm. 402 Fee $21

Creating a Photobook with DigitalPicturesInstructor: N. VanSpeybroeckPrerequisite: Sharing Photos OnlineLevel 2 - Have you accumulated lots of digital photos but have yetto have them printed and put in a scrapbook? Create a photobook,quickly and easily, using your Shutterfly account that you openedin the Sharing Photos Online class. Select beautiful backgroundsfor your pages, a cover, fancy edges for your pictures and more.Please note: It is free to create a photobook on Shutterfly, but ifyou choose to order an actual book, there is a cost. You may uploadyour photos to Shutterfly prior to class or bring them on a flash driveor CD.1 Monday Oct. 6 8:30 - 10:30 a.m.CRN 81877 Outreach - Rm. 402 Fee $21

Instructor Nora VanSpeybroeck

Black Hawk CollegeOutreach Center (Outreach)

301 Avenue of the Cities, East Moline, IL

Black Hawk CollegeAdult Learning Center (BHCALC)

4610 Blackhawk Commons Drive (11th St.), Rock Island, IL

FacebookInstructor: N. VanSpeybroeckLevel 1 – Connect to the world through Facebook. Find friendsand relatives, join interest groups and more. Send messages andwrite on your friends’ “timelines.” View your friends’ photos andvideos as well as upload your own. You will have the opportunityto set up a free Facebook account in class and learn how to secureit with the proper privacy settings. If you have an email account,please bring to class your email address and password to accessyour web mail.3 Mondays Sept. 8 - Sept. 22 9:30 - 11:30 a.m.CRN 81878 Outreach - Rm. 402 Fee $42

Pinterest Instructor: N. VanSpeybroeckLevel 1 – What’s all the talk about Pinterest? This class will showyou why there are more than 50 million users. Pinterest is a toolfor collecting and organizing the things that interest and inspireyou. You can easily organize information and photos of ideas forevents, crafts, home decorating, fashion, hobbies, travel, recipesand more. Learn how to “pin” items to the “boards” you create.Join us and spark your creativity!1 Monday Nov. 17 8:30 - 10:30 a.m.CRN 81879 BHC ALC - Rm. 112 Fee $21

Evening Health andWellness ClassesOptions for Seniors: How to Access Aging ServicesInstructor: T. Harper Caregivers and seniors will learn about local and federal seniorservices and how to access them for successful aging. Housingoptions, nursing home care, hospice, at-home services andcommon health concerns in the aging population will bediscussed.Topics will include:• Advanced directives and a brief discussion on estate

planning for the elderly.• Differences between assisted living, supported living, senior

apartments and nursing home care.• Alzheimer’s disease and other age-related illnesses.• In-home services such as home health, hospice care housing

options, Medicaid services and VA services.5 Wednesdays Sept. 3 - Oct. 1 6:00 - 7:30 p.m.CRN 81790 Outreach - Rm. 104 Fee $48

Caregiver Stress and CompassionFatigueInstructor: J. Grice With improved medical care and higher standards of living, lifeexpectancy has increased and this can cause a wide set of issues,demands and emotions for those who are entrusted with caring forour ill or disabled. Learn strategies on how to avoid total burnoutand take care of you while taking care of others.1 Thursday Nov. 6 6:30 - 8:00 p.m.CRN 81791 Outreach - Rm. 104 Fee $15

Heart Disease Prevention Instructor: Dr. P. Newhouse Have you ever wondered why your body makes cholesterol all onits own if it’s bad for you? Why do many cholesterol drug adsstate “not proven to decrease your risk of heart disease or heartattack”? Learn the truth about heart disease prevention and nat-ural solutions to find “The New You.” 1 Tuesday Sept. 23 7:00 - 8:30 p.m. CRN 81797 Outreach - Rm. 407 Fee $29

1 Tuesday Oct. 21 7:00 - 8:30 p.m. CRN 81798 Outreach - Rm. 407 Fee $29

Decision Time: Understanding Medicareand Medicaid Instructor: R. VolkerJoin in an informative and interactive program that will provide youwith a better understanding of Medicare and Medicaid. Topics willinclude Medicare eligibility and enrollment, the benefits ofMedicare Parts A and B, the costs that Medicare leaves you to payand an overview of the standardized Medicare Supplemental Plansin addition to Medicaid “spend-down” requirements. This programis appropriate for people becoming eligible for Medicare,caregivers of people who are on Medicare and current Medicarebeneficiaries who would like a refresher course on their benefits.3 Wednesdays Oct. 1 - Oct. 15 7:00 - 8:30 p.m.CRN 81959 Outreach - Rm. 204 Fee $34

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How to registerCall the Professional and Continuing Education (PaCE)department at 309-796-8223. MasterCard, VISA, andDiscover Cards accepted.

Mail registration form along with payment to: Black Hawk College - Outreach Center Professional and Continuing Education (PaCE)301 Avenue of the Cities, East Moline, IL 61244

Make checks payable to: Black Hawk College

Business Hours:Monday - Thursday 8:00 a.m. - 7:00 p.m.Friday 8:00 a.m. - 5:00 p.m.

Online - Go to www.bhc.edu/pace. Click on Continuing EdRegistration and then select a PaCE schedule.

Refund policyCall 309-796-8223 no later than 24 hours (one full workingday) before your class starts to receive a 100% refund—unlessotherwise noted. Drops must be done by phone or in person atthe PaCE Office.

Black Hawk College will make all educational and personnel decisions withoutregard to race, color, religion, gender, sexual orientation, marital status, nationalorigin or ancestry, age, physical or mental disability unrelated to ability, or sta-tus as a disabled veteran or Vietnam era veteran, except as specifically exempt-ed by law. If you need an accommodation based on disability to fully partici-pate in this program/event, please contact Disability Services at 309-796-5900,309-796-5903 (CAPTEL) or 309-716-3310 (video phone). Please allow suffi-cient time to make arrangements.

New

New

New

Hispanic or Latino Ethnicity: __ Yes __ No Race: (choose one or more):___ (20) American Indian/Alaskan Native___ (10) Asian ___ (30) Black or African American___ (70) Native Hawaiian/Pacific Islander___ (50) White ___ (60) Choose Not to RespondPrimary Race/Ethnicity: (select one):___ (20) American Indian/Alaskan Native___ (10) Asian ___ (30) Black or African American___ (40) Hispanic or Latino___ (70) Native Hawaiian/Pacific Islander___ (50) White ___ (60) Choose Not to RespondAre you a United States Citizen? __ Yes __ NoAre you a permanent resident of the United States? __ Yes __ NoAre you here on a Visa? __ Yes __ No

If Yes, what is your home country of origin?___________Student Intent: (Check one)___ (01) Prepare for new or first occupational career___ (02) Improve present occupational skills___ (03) Explore courses to decide on a career___ (04) Prepare for transfer to 4-yr. college or Univ.___ (05) Remedy basic skills deficiencies___ (06) Pursue non-career, personal interests___ (07) Prepare for high school diploma equivalence test___ (08) Other or unknownHighest Degree Previously Earned:___ (30) GED ___ (35) High School Diploma___ (39) Some college (No degree)___ (40) Certificate___ (45) Associate Degree___ (50) Bachelors Degree___ (60) Masters Degree___ (70) First Professional Degree___ (80) Doctorate Degree___ (85) Other___ (90) NoneEmployment Status:___ (01) Full Time—40 hrs. or more ___ (02) Part Time—over 15 hrs/week___ (03) Part Time—15 hrs or less/week___ (04) Homemaker___ (05) Unemployed___ (06) Retired/Other

Social Security Number:_________/______/_________ Birth Date:_____/_____/_______

Name:__________________________________________________ Male___ Female___ (Last) (First) (Middle Initial)

Home Address:_____________________________________________________________

City:______________________________________ State:_________ Zip:____________

Home Phone:______________________ Business Phone:_________________________

Cell Phone:________________________ Email: ________________________________

____________ _______________________________________________ ____________

____________ _______________________________________________ ____________

____________ _______________________________________________ ____________

Date:___________ Rec’d By:_________ Cash:____ Check#______________ Charge:____ _______________Total Due

CRN Course Name Amount Due

PaCEBHC - Outreach Center

301 Avenue of the CitiesEast Moline, IL 61244

309-796-8223

Informationcollected in

this section isused to

comply withFederal and

State reporting

requirements.

Hispanic or Latino Ethnicity: __ Yes __ No Race: (choose one or more):___ (20) American Indian/Alaskan Native___ (10) Asian ___ (30) Black or African American___ (70) Native Hawaiian/Pacific Islander___ (50) White ___ (60) Choose Not to RespondPrimary Race/Ethnicity: (select one):___ (20) American Indian/Alaskan Native___ (10) Asian ___ (30) Black or African American___ (40) Hispanic or Latino___ (70) Native Hawaiian/Pacific Islander___ (50) White ___ (60) Choose Not to RespondAre you a United States Citizen? __ Yes __ NoAre you a permanent resident of the United States? __ Yes __ NoAre you here on a Visa? __ Yes __ No

If Yes, what is your home country of origin?___________Student Intent: (Check one)___ (01) Prepare for new or first occupational career___ (02) Improve present occupational skills___ (03) Explore courses to decide on a career___ (04) Prepare for transfer to 4-yr. college or Univ.___ (05) Remedy basic skills deficiencies___ (06) Pursue non-career, personal interests___ (07) Prepare for high school diploma equivalence test___ (08) Other or unknownHighest Degree Previously Earned:___ (30) GED ___ (35) High School Diploma___ (39) Some college (No degree)___ (40) Certificate___ (45) Associate Degree___ (50) Bachelors Degree___ (60) Masters Degree___ (70) First Professional Degree___ (80) Doctorate Degree___ (85) Other___ (90) NoneEmployment Status:___ (01) Full Time—40 hrs. or more ___ (02) Part Time—over 15 hrs/week___ (03) Part Time—15 hrs or less/week___ (04) Homemaker___ (05) Unemployed___ (06) Retired/Other

Social Security Number:_________/______/_________ Birth Date:_____/_____/_______

Name:__________________________________________________ Male___ Female___ (Last) (First) (Middle Initial)

Home Address:_____________________________________________________________

City:______________________________________ State:_________ Zip:____________

Home Phone:______________________ Business Phone:_________________________

Cell Phone:________________________ Email: ________________________________

____________ _______________________________________________ ____________

____________ _______________________________________________ ____________

____________ _______________________________________________ ____________

Date:___________ Rec’d By:_________ Cash:____ Check#______________ Charge:____ _______________Total Due

CRN Course Name Amount Due

PaCEBHC - Outreach Center

301 Avenue of the CitiesEast Moline, IL 61244

309-796-8223

Informationcollected in

this section isused to

comply withFederal and

State reporting

requirements.

Method of Payment--Check One

Credit Card

Month Year

Credit Card Signature___________________________________________________________

Security CodeExp. Date ____________________Cardholder Zip Code

Check/Money Order VISA MasterCard Discover

Method of Payment--Check One

Credit Card

Month Year

Credit Card Signature___________________________________________________________

Security CodeExp. Date ____________________Cardholder Zip Code

Check/Money Order VISA MasterCard Discover

BLACK HAWK COLLEGE6600 34TH AVEMOLINE IL 61265-5899

Professional andContinuing Education

presents:

Lifelong Learner Program

(Formerly Golden Scholars/Golden Opportunities)

Especially designed for anyone celebratingyears of 55 or better,

but all learners are welcome!

For more information, please call 309-796-8223.

www.bhc.edu

August - December 2014