ETOM Online Teacher Certification (Canvas)
* Required
First Name
*
Your answer
Last Name
*
Your answer
Title/Position
*
Example: Professor
Your answer
Department
*
Example: Math
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
E-mail
*
Type carefully. This e-mail address is used: (1) for all communications; (2) to create your user account; and (3) to send your completion certificate.
Your answer
Phone
*
Please include your area code (XXX-XXX-XXXX).
Your answer
Institution
*
Select your ETOM member institution or select "Non-Member."
Choose
Alpena Community College
Bay College
Delta College
Ferris State University
Glen Oaks Community College
Gogebic Community College
Grand Rapids Community College
Grand Valley State University
Henry Ford College
Jackson Community College
Kellogg Community College
Kirtland Community College
Lake Michigan College
Lawrence Technological University
Macomb Community College
Madonna University
Michigan Technological University
Mid Michigan Community College
Monroe County Community College
Montcalm Community College
Mott Community College
Muskegon Community College
Washtenaw Community College
North Central Michigan College
Northwestern Michigan College
Northwood University
Oakland Community College
Oakland University
Olivet College
Saginaw Valley State University
Schoolcraft College
St. Clair County Community College
Wayne County Community College
Wayne State University
West Shore Community College
WMU-Cooley
Non-Member
Non-Member
If you selected "Non-Member" from the drop-down above, list your non-member institution, business or "N/A."
Your answer
Name of Person Responsible for Payment
*
Select "Me" if you will be paying for this certification - even if you will be reimbursed by another party. If you enter a name under "Other", you will need to provide their contact information in the next section (and they will receive a notification).
Me
Other:
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