Continuing Education Unit Form
The Seattle School of Theology & Psychology
Office of Admissions
2501 Elliott Avenue
Seattle, WA. 98121
888.977.2002
[email protected]
theseattleschool.edu/admissions
INSTRUCTIONS
• This form is for reporting of CEU credits only. You must also submit either course registration or an enrichment application in order to attend the
class. Please include full payment for the applicable tuition and CEU credits.
• Make checks payable to The Seattle School of Theology & Psychology.
• This application form is only for students desiring Continuing Educational Credit only, not Graduate Credit. If you desire credit, you should complete
the application for admission into a degree program.
• CEU students will not have their work graded. Please be aware that credit cannot be granted after the fact; your decision to receive or not receive
credit is final for each course and must be submitted at least 7 days before the first class meeting.
• No refunds or reimbursements will be extended to registrant’s who miss class in part or in full. Cancellation must be received in writing at least 7
days in advance of the course.
CEU FORM
Note: Please write clearly in ink for all forms.
contact information
first Name
last Name
Middle
Phone
Email Address
Mailing Address
City
StateZIP
How and when did you first hear about The Seattle School of Theology & Psychology?
Who or what influenced you to apply? (check all that apply)
q The Seattle School Faculty q Visit to Campus
q Teacher or Professor
q Counselor or Therapist
q The Seattle School Publication q The Seattle School Alumnus
q Other: q Admissions Representative
q The Seattle School Website
Pastor
or
Minister
q
q Family or Friend
q Current Seattle School Student
requested courses
What is your desired term of enrollment? q Fall q Spring q Summer Year Course Number
Course Title
Seat Hours
payment
Each CEU seat hour is $30. To calculate the costs for your CEUs, multiply the number of seat hours by $30.00.
Number of Seat Hours × $30.00 = $
(total)
You can send a check made out to The Seattle School of Theology & Psychology along with your application, or pay by credit card by filling out the form
below, authorizing The Seattle School to bill your credit card for the application fee.
Name on card
q Yes, please bill my credit card for the total cost of my CEUs.
card numberexpiry date
Billing Address
City
StateZIP
compliance
My signature below indicates that all the information contained in my application is complete and correct. I understand that any falsification of
information is grounds for expulsion.
Applicant’s Signature Date The Seattle School of Theology & Psychology actively subscribes to a policy of equal education opportunity for all people and does not discriminate on the basis of race, ethnicity, national origin, sex, age, disability, or
other characteristics protected by law. This policy is in compliance with Titles VI and VII of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, and Section 504 of the Rehabilitation Act of
1973. Students have specific rights that are guaranteed by the Family Educational Rights and Privacy Act of 1974. The Seattle School of Theology & Psychology has a policy prohibiting sexual harassment. Inquiries
regarding compliance with federal, state, and local laws should be directed to the Office of the President.