Course Registration Form

Back to Algebra I

CONVERSE COLLEGE

SPARTANBURG, SOUTH CAROLINA

in partnership with South Carolina Educational Communications

ALGEBRA I CONTENT REFRESHER FOR TEACHERS - MTE 506

3 semester credits

COURSE REGISTRATION FORM

(SEE DIRECTIONS BELOW - AT THE END OF THIS FORM)

Social Security Number: (xxx-xx-xxxx)

Last: First Middle/Maiden

Ethnic Information: Birth date: Sex: Male: Female:

Mailing Address:

City: State: Zip: Citizenship

Work Phone: Home Phone: email:

Other name, if applicable:

Signature of Student __________________________ Date:

DIRECTIONS

(Note: These directions are for your use and do not need to be submitted)

1. Complete (type-in) in the information above and then PRINT THE FORM. This is NOT an electronic registration so your information is not submitted online.

NOTE: The DVDs that are sent play ONLY on DVD players (connected to a TV or one that is inside a personal computer). A CD Player will not play these DVDs.

2. PAYMENT: South Carolina Educational Communications is responsible for the financial and logistical arrangements for this course on behalf of Converse College.

      Submit $484 for each course:

        a. Using either a personal check or school/district Purchase Order payable to: SC Educational Communications, Inc.    OR

        b. Credit Card Payment - Click on this link to see the credit card entry form.
            (Print and include with the registration form)

3. Mail to: (Expect to receive your materials within 7-10 working days)

    South Carolina Educational Communications
     Attn: Ms. Amy Raffo,
    401 E. Kennedy Street, #B-1
    Spartanburg, SC 29302

FAX: If you are using a credit card or Purchase Order you can FAX your materials to: 864-573-7792. For FAXes only, an email confirmation will be sent upon receipt of the FAX. If you do not receive a confirmation of your FAX within one business day please contact Amy Raffo at araffo@bellsouth.net or 864-585-0102

4. Your Start and Completion Dates are based on the date ON THE REGISTRATION FORM next to your signature.
    You can complete a course at any time on or before the deadline date- see   Completion Schedule
    When you complete a course your grade is posted and a Transcript can be obtained within 7-10 working days.

5. If you have questions other than Registration, contact: Dr. Stan Rachelson, srachelson@scetv.org, 770.369.1664