Graduate Music Education
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Conference Credit Registration

MMEA Conference Graduate Credit Registration

No payment is due at the time of registration. Students will be billed directly from the Office of Student Financial Services at Gordon College within a week after the MMEA Conference, February 27 - March 2, 2013.

If you wish to withdraw your registration, you must do so in writing by email to kristen.harrington@gordon.edu. Failure to submit the required assignment does not constitute a withdrawal from the course, and the student will be responsible for payment of tuition in full.

1. First Name

2. Last Name

3. Birth Name (For Gordon College Alumni Only)

4. Primary email address

5. Mailing Address

6. City, State, Zip

7. Birth Date (mm/dd/yyyy)

8. Gender

Male
Female

9. Please indicate which of the following best describes your ethnicity (optional)

10. Bachelor's Degree Institution

11. Bachelor's Institution Location

12. Degree Conferred

13. Date of Conferral

14. Your name at the time of conferral

15. Have you previously registered for a graduate course or workshop at Gordon College?

Yes
No

16. How did you find out about the opportunity to receive graduate credit for your participation in the MMEA All-State Conference?

Email message
Word of mouth
Gordon College Graduate Music Website
Brochure mailing
Gordon College Graduate Information Session
MMEA Conference Registration Website
On site at the MMEA Conference Registration Area

17. My initials bellow indicate that all information contained in this form is factual and complete. I understand that the misrepresentation or omission of information is sufficient grounds for canceling my registration. I have read and agree to the course withdrawal policy as indicated above.