Application/Registration for Academic Workshops, College of Education Send to: College of Education Office of Professional Learning CHCS 316 Akron, OH 44325-4201 Last Name (Legal Name) First Mid Init (Former Last Name) Home Address (No. & Street) City State County (Ohio only) Date of Birth State of Birth E-mail address Sex Social Security No.* Zip Home Phone (area code) Student ID (Office use only) Please CHECK one of the following: (Required for Federal Reporting by Civil Rights Act of 1964) Native American African American/Black Asian American Spanish /Latino Caucasian/White American **Date Ohio Residence Established:** (If NOT born in Ohio) Please CHECK one of the following: Month Day Name of Employer Single Married Work Phone Number (with area code) Year College Degree(s) Awarded (Including the University of Akron) College or University Name of Degree Workshop Information No. Term Divorced Major Field Title 5500:592 NonRes./Alien Widowed Date Awarded Credits Cost 1 $150.00 GRADING METHOD: Graduate (500) (Credit/Noncredit) Method of Payment (Select One) Check No. Make checks payable to The University of Akron Online Payment Log in: CashNet: https://commerce.cashnet.com/akronpay?LT=N (please see reverse side for directions) You can pay online either by electronic check (no fee) or by credit card (2.9% processing fee). I understand that once this registration has been signed and processed it cannot be changed. It is a commitment to pay all tuition costs and I will remain registered unless I take action to cancel my registration prior to the end of the first day of the workshop. After the first day of the workshop, tuition is non-refundable. I certify to the best of my knowledge the information herein is complete and accurate. I hereby grant permission to The University of Akron to seek and exchange any information with the secondary schools, colleges, or universities I have attended. I further authorize any such institutions to release any records or confidential information concerning The University of Akron. As required by law, The University of Akron does not discriminate on the basis of sex, race, age, religion or ethnic origin in its educational programs, activities, or employment. ________________________________________________________ _______________________________________ Signature Date *Social Security numbers are required by all colleges and partners for Federal reporting purposes. NOTE: Please see Page 2 for important information on Paying Online, Dropping a Workshop, Grading, Transcripts and Contacts. The University of Akron Important Information about Registering for Workshops Dropping a Workshop and Refunds: Once this registration has been signed and processed it cannot be changed. It is a commitment to pay all tuition costs and you will remain registered unless you take action to cancel your registration prior to the end of the first day of the workshop. After the first day of the workshop, tuition is non-refundable. To review the University’s refund policy, go to: http://www.uakron.edu/student-accounts/refunds/ Application Denial: If a student previously enrolled at The University of Akron is not in good standing with The University of Akron, his/her application may be denied for registration and/or graduate credit. The student will be notified if his/her application is not accepted. Online Payment: There are two options when paying your bill online: Option 1 is to pay by credit card. Please note that an additional 2.9% processing fee will be added to your bill. Option 2 is to pay by electronic check (no additional fee) Below are the instructions on how to pay your bill online: Go to our CashNet website link to pay your bill directly: https://commerce.cashnet.com/akronpay?LT=N Once you are on the CashNet page, you will need your Student ID (Login) and full name as listed on your account with us. Please use the following information Login: (your student ID#) Last Name,First Name MI (please no space between last & first name and only 1 space for middle initial) Follow the prompts to make your payment. If you do encounter a problem you may contact the Office of Student Accounts at 330-972-5100. If you prefer, you can always mail a check to the following address – make sure to put your ID# on your check for easier processing: The University of Akron, Office of Student Accounts P.O. Box 2260 Akron, Ohio 44309-2260 Grading Method: This is a graduate-level workshop (500) and you must have a bachelor’s degree in order to receive graduate-level credit. Workshops are graded as Credit/No Credit; no letter grade will be issued. NO CEU’s will be given when graduate credit is awarded. Contacts University of Akron Main Campus: Zipline: Springboard: http://www.uakron.edu http://zipline.uakron.edu https://springboard.uakron.edu/index.asp College of Education Office of the Dean and Office of Professional Learning Karen Greene 330-972-2632 email: uaonline@uakron.edu Website: http://www.uakron.edu/education/current-students/prof-learning/index.dot University Transcript Requests, Office of the Registrar You may request a FREE transcript in person, by phone or fax, or online. In Person: 100 Simmons Hall Phone: 330-972-8300 Fax: 330-972-6097 Online: To obtain a form, go to: http://www.uakron.edu/registrar/services/transalumni.dot or email greene@uakron.edu and we will be more than happy to email you the Transcript Request link. Please note that transcripts will not be released if there is an outstanding balance on the student account.