Enhancing the Reading Classroom with Technology: In-Service Registration Form

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Title *

First Name *

Last Name *

First Time Student? *

Are you taking this course for in-service credit, or graduate credit? *

If you are taking this for graduate credit, you are filling out the wrong form. Fill out the "Graduate Course Registration" on the graduate page.

If you are taking this for graduate credit, you are filling out the wrong form.

Primary Email Address *

Please provide the email address you primarily use outside of school. AN AUTOMATIC EMAIL WILL BE SENT TO THIS EMAIL ADDRESS IMMEDIATELY AFTER YOU SUBMIT THIS FORM WITH FURTHER INSTRUCTIONS.

School Email Address *

You need to provide a Gmail address in order to join the class. This may be the same as your primary address that you provided above. *

This cannot be your school address.

Does your school use Google Apps for Education? *

Street *

City *

State *

Zip Code *

Cell Phone *

School District *

Subject(s) Taught *

Grade(s) Taught *

What semester are you taking the course(s)? *

How did you hear about us? Check all that apply. *

Facebook

Brochure

Twitter

Word of Mouth

Other:

Required

First Time Students: Please enter the name of the person who first introduced you to Ed Technology Specialists

Enter the First and Last Name.

After hitting "Submit", please be sure to pay your tuition. In addition, you will immediately be sent an email (to your primary email account) with further instructions to start the class. Please check your inbox or spam box right after you hit "submit" to receive the directions. THANK YOU!

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