University of Southern Maine - Course Registration

University of Southern Maine - Course Registration

Credit Options and Costs

Option One: GRADUATE CREDIT

EPA 522-51 Earth Science Online for Elementary School Teachers

EPA 567-51 Earth Science Online for Secondary School Teachers

These courses are approved for three (3) graduate credits by the University of Southern Maine (USM),

College of Education and Human Development.

USM Graduate Credit (3 units) and fees: $655.50

Gulf of Maine Aquarium Scholarship: $300.00 (credit)

For Graduate Credit, Student Pays: $355.50

Option Two: CONTINUING EDUCATION UNITS (CEUs)

EDIS 1123-51 Earth Science Online for Elementary School Teachers

EDIS 1087-51 Earth Science Online for Secondary School Teachers

These courses are approved for 4.5 CEUs.

CEU Credit (4.5 CEUs) Registration Fee: $25.00

Registration Form

......

Semester (check one) O Fall O Spring O Summer Date ______/______/______

Name ______Social Security # ______

Home Address ______Telephone ______

City ______State ______Zip ______

Local Address (street, city, state, zip) ______

Birthdate _____ / _____ / _____ O Male O Female

Is this your first registration at USM? _____ Is this a new local address? _____ home address? _____ Have you resided in Maine,

for purposes other than education, during the 12 consecutive months immediately prior to enrollment? O Yes O No

Place a (√) mark in the circle next to the credit option of given choice.

Graduate Credit/3 Units

Course Number/Title Payment Due

O EPA 522-51 Earth System Science Online For Elementary School Teachers (formally EIPD 572-51) $355.50

O EPA 567-51 Earth System Science Online For Secondary School Teachers (formally EIPD 560-51) $355.50

Continuing Education Units / 4.5 CEUs

Course Number/Title Payment Due

O EDIS 1123-51 Earth System Science Online For Elementary School Teachers $25.00

O EDIS 1087-51 Earth System Science Online For Secondary School Teachers $25.00

Method of Payment: Make Payable to University of Southern Maine

O Purchase Order Number ______Amount $ ______

Institution (name) ______

Address (Street, City, State, Zip) ______

O Credit Card (circle one): Visa, MasterCard, Discover Amount $ ______

Card Number: ______/______/______/______Expiration Date: ______/______

Signature: ______

Mail or FAX To: Professional Development Center, College of Education and Human Development,

University of Southern Maine, 305 Bailey Hall, Gorham, ME 04038

FAX: (207) 780-5358