Sheltered English Immersion Endorsement for Non-matriculated Students

Sheltered English Immersion Registration

Please complete this online form to register for graduate credit. If you would like a copy of this form for your records, be sure to print it PRIOR to submission!

1. Course dates (e.g. 3/4/2013-3/29/2013)

2. Which SEI course are you taking?

Short Bridge for TEACHERS (1 credit) - 10.5 hours
Long Bridge for TEACHERS (2 credits) - 24 hours
Full Course for TEACHERS (3 credits) - 45 hours
ADMINISTRATOR'S Course (1 credit) - 15 hours

3. Last name

4. First name

5. Middle name or initial

6. Maiden name (if applicable)

7. Date of birth (Month, Year – i.e. May, 1973)

8. Primary phone

9. Email

10. What is your MEPID #? (Your MA teacher ID#)

11. At which location are you taking the course?

12. Who is the course instructor?

13. I have read Gordon College's Registration, Withdrawal, and Refund Policy, and I agree to comply with its stipulations.

I agree

14. If upon completion of courses a balance is due on my account, I will be charged an interest rate of 15% annually (1.25% monthly). If my account is turned over to a collections agency, I understand I will be responsible for all collection and legal costs.

I agree, and by selecting this option I accept all terms.

15. If I should have a credit balance on my student account, I authorize Gordon College to hold that credit until I request a refund.

I agree

16. Comments/Questions:

17. I consent to allow Gordon College to obtain my SEI course grade from DESE. (Consent is necessary in order for you to receive graduate credit for your SEI course from Gordon College). We will not register you for credit without this consent.

I agree, and by selecting this option I accept all terms.