Please fill in this form COMPLETELY for timely processing of your registration. Completed forms will receive an automated confirmation from the website.
Upon successful completion of this course, AND after teaching a fully online course with assistance from a Distance Learning mentor, the University will provide a one-time stipend of $1,000 to the participant. Be sure to notify Elizabeth Alexander (firstname.lastname@example.org) when you are assigned to teach your first online course, so we can assign a mentor who will help you transition into teaching your online course.
If you do not complete the form correctly, this may delay your ability to be enrolled. Click the SUBMIT button at the bottom of this form, when completed.