Regent University School of Education

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Register for Workshops

To register, please complete and submit the following online form.


  • Space is available on a first come, first served basis.
  • Each individual participant will receive an email confirmation as soon as is possible after receipt of registration forms. Please be patient.

 

PERSONAL INFORMATION
Title:*
First Name:*
Last Name:*
Email:*
Have you previously registered to receive graduate credit for a Martinson Center course?*   Yes   No
Do you have a Bachelors degree?*   Yes   No
Are you a U.S. citizen?*   Yes   No
Please fill out the following information. It is required as a matter of legal reporting requirements applicable to Regent University. It will not be taken into account in any admission or academic decision, nor in the administration of any program at the University.
Gender:* Male   Female
Date of Birth:*    
Ethnic Origin:*

 

HOME CONTACT INFORMATION
Street Address:*
City:*
State:*
Zip:*
Country:*
Phone:* ()

 

EMPLOYMENT INFORMATION
Place of Employment:*
School Division:

If not listed above, choose "Other" and enter here:
Occupation/Title:
Street Address:*
City:*
State:*
Zip:*
Country:*
Work Phone: ()

 

WORKSHOP REGISTRATION TYPE
You may register to take the workshops with or without graduate credit. Please select your choice below:

Graduate credit worth 30 License Renewal Points per credit
License Renewal Points only - no graduate credit

How did you hear about the workshops?



If you heard about this workshop from a friend/colleague, please give us his/her name below. That person will be entered in a drawing for a $25 gift card.

I was referred by: