Graduate Education
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Sheltered English Immersion Endorsement Course

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 (mm/dd/yyyy)

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: