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CONVERSE COLLEGE

SPARTANBURG, SOUTH CAROLINA
in partnership with South Carolina Educational Television

 

MIDDLE MATHEMATICS CONTENT REFRESHER FOR TEACHERS - MTE 500

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: (No P.O's)

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)

THE PAYMENT FOR THIS COURSE GOES TO A DIFFRENT PERSON AND ADDRESS THAN THE OTHER COURSES!

1. Complete (type-in) in the information above and then PRINT THE FORM.
2.  PAYMENT: NOTE: THE PAYMENT FOR THIS COURSE GOES TO A DIFFERENT PERSON AND ADDRESS THAN THE OTHER COURSES!
Because this course is funded by the Star Schools program of the United States Department of Education under contract R203A970032, payment is made to the grantee: the Satellite Education Resources Consortium (S.E.R.C.) on behalf of Converse College.
The course fee for registrants in the S.E.R.C. member states: Florida, Kentucky, Louisiana, Nevada, South Carolina, Virginia, and West Virginia is: $444.
For registrants living OUTSIDE THE ABOVE AREAS, the course fee is: $484.
3. PAYMENT METHODS:
      a. Submit with a personal check or school/district Purchase Order payable to: S.E.R.C.
      b. Credit Card Payment - Click on this link to see the credit card entry form.
          After completion, print it and mailed with the registration form
4 . Send To: Beck Frazier, c/o SERC, PO Box 50008, Columbia, SC 29250
      If you have Registration questions, contact Beck at: 800-507-7322 (Extension 100) or email: beckf@netaonline.org 
FAX:  If you are using a credit card or Purchase Order you can FAX your materials to: 803-771-4831.  
5. 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 days.
6.  If you have course questions, contact: Dr. Stan Rachelson, srachelson@scetv.org, 770-369-1664.