Registration - Arcadia University

[ * = required information ]

Student Information

First Name *

Last Name *

Address *

Address 2

City *

State Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *

Zip *

Email *

Phone *

Date of Birth (Format: mm/dd/yyyy) *

Gender Female Male *

U.S. Citizen Yes No *
If non-citizen, list country & type of visa

* Social Security number will be required to complete registration.

Employer Information

Employed Yes No *

Title

Address

Address 2

City

State Select Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip

Phone

Current Status

Academic Goal...*
  Seeking a Graduate degree at Arcadia University
 Seeking Professional Development
  Seeking Graduate Certificate in Extending Learning

Which Summer Institute(s) will you be taking? Check all that apply.*

  Teaching and Learning in Extended Learning Environments (July 26–28)
  Extending Opportunities for English Learners (July 29–31)

If seeking a degree, which concentration...
 

Are you currently enrolled in another College / University Yes No *

Have you earned an Undergraduate Degree? Yes No *

Payment *

Enrollment is not complete until payment is received.

Online* By phone By check (Payable to Foundations, Inc) By Purchase Order

Note: if paying online, you need to check out via the store.

Comments/Questions

Please re-enter the text above

Refund Policy
Requests for refunds must be received in writing prior to July 2, 2010. Refund requests
postmarked before May 28, 2010 will be eligible for a full refund less a $75 administrative
fee. Refund requests postmarked after May 28, and before July 2, 2010, will be eligible for a
70% refund. No refunds can be made for requests postmarked after July 2, 2010.

In the event of Institute cancellation, registered participants will receive a full refund and up to
$100 for fees associated with changes to purchased airline or train tickets (only with proof of
ticket purchase prior to cancellation notice).

I have read and agree to the refund policy.