ESC of Northeast Ohio/Kent State Partnership Workshop Registration Form
A 20% discount will be applied to any tuition charge. A $12 per credit hour distance learning fee is assessed and not subject to the discount.
Workshop Registration Form
ONLINE PAYMENT ONLY Once registered a confirmation email with online payment directions will be sent to you. Please allow 3-5 business days to process. Workshops are graded S for satisfactory and U for unsatisfactory. An S is equivalent to an 80% or better for graduate level work. Transcripts are FREE by going to www.kent.edu/registrar/transcript-requests. Direct registration questions to pd@kent.edu.

*This form is secure and meets FERPA guidelines. All personal information is kept secure and is not used by anyone outside of Kent State University.*
Workshop Title (Complete a separate registration form for each workshop for which you are registering.) *
Your answer
Department (Example: CI, CES, EDAD, HDFS, ITEC) *
Your answer
Course Number *
Required
How Many Credits *
Required
Name of the School District that you are employed: *
Name *
First Name, Middle Initial, Last Name
Your answer
Other name(s)
Maiden name, etc.
Your answer
Address *
Street Address, City, State, Zip
Your answer
County
Ohio Residents only
Your answer
Have you lived at this address for the last 12 months? *
Required
If you have lived at this address less than 12 months, please list all the addresses where you have resided in the last 12 months.
Your answer
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