Southeastern Louisiana University Dual Enrollment Workshop Registration--Summer 2016
Please make sure that you include all of the information requested. As a Southeastern Dual Enrollment teacher, you will be issued a University Identification number that will be used to access Moodle, Library Services, the Dual Enrollment Registration System and Southeastern Gmail. Registration deadline is May 31 , 2016.
Personal Information
Information that you enter will only be used to generate an identification number to use at Southeastern.
Last name:
Your answer
First name:
Your answer
I ___________ participated in Southeastern's Dual Enrollment program before.
If you have not taught the course for the workshop you are attending, please be aware there is a 1/2 day workshop towards the end of the summer you must attend.
Do you have a Southeastern "w" number? If so, please enter it below.
Did you ever attend, work, send ACT scores or apply to Southeastern? If so, you would have been assigned a w number. If the answer is yes but you do not know your w number, please check "yes" and "I'm not sure".
W number (if known):
A sample w number would be w0211389
Your answer
Date of Birth (MM/DD/YYYY)
If your birth date is April 30, 1970, enter 04/30/1970
MM
/
DD
/
YYYY
Which of the following best describes your reason for attending our workshop?
High School Information
The high school you will be teaching from:
Your answer
The email address that you use for work:
Your answer
High School Phone Number
Your answer
The name of your high school Principal:
Your answer
Campus Dual Enrollment Coordinator:
Your answer
Course Workshop Information
My school is planning to offer this course: (check all that apply)
To better help our coordinators assist you in planning your course, the following information is required. We realize scheduling changes from day to day so please provide the information to the best of your ability.
Required
Please indicate below the course workshop(s) that you will be attending. For half-day workshops please see the next question.
You may check all course workshops you plan to attend.
ALL teachers, new and returning, must attend a 1/2 day workshop. Therefore, please select the half-day workshop(s) that correspond(s) to the course(s) you intend to teach.
Thank you for choosing to partner with Southeastern. We are looking forward to another record-breaking year. You may add any comments in the box below.
Your answer
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