MANHATTANVILLE COLLEGE and CHILDREN’S ENVIRONMENTAL LITERACY FOUNDATION GRADUATE CREDIT REGISTRATION FORM SUMMER II 2017 DATE:____________________
LAST NAME: _________________________ FIRST:_______________________ MI:_____
ADDRESS:
PHONE:
Street ____________________________
Home:_____________________
____________________________
Cell:______________________
City ____________________________
EMAIL:____________________
State:________ Zip:__________
SSN:______________________
Male Female
DOB:_____________________
PLEASE CHECK THE COURSE(S) YOU ARE REGISTERING FOR:
Selection
DEPT
Course #
Sect
Title
Instructor
P/F
Credits
EDU
5549
01
Sustainability Education Institute
Staff
2
EDU
5551
01
Environmental Concepts Curric.
Staff
1
SCHEDULE
Mon-Thurs
July 10-13
Thurs
July 13 +
Implementation
Report
I agree to abide by all policies and procedures as stated in Manhattanville College’s publications including payment of all charges and
collection fees.
REQUIRED STUDENT SIGNATURE ________________________________________________________________________________________
DATE
DO NOT ATTACH PAYMENT. Invoice will be sent.
OFFICE USE ONLY
Date entered:__________________
Entered by:____________________
Tuition: $305 per credit
ADVISOR USE ONLY
Student Residency/Discount Code: ___________
Signature:________________________________
Date: _________________
RETURN COMPLETED FORM TO:
Prof. Laurence Krute
Manhattanville College Graduate School of Education
2900 Purchase St, Purchase, NY 10577
Phone: 914-323-5366 / Fax: 914-323-5493
Email: [email protected]