EIU EDL -- Official Course Registration Form

Utilize this form to request to be enrolled into EIU EDL course(s) as part of a cohort, etc.

Semester: *
Year: *
E-Number: *
Name: Name: * First Last
Address: Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Cell Phone: Cell Phone: * - ### - ### ####
EIU Email: *
Home Email: *
Work Email:
On- or Off-Campus cohort member: *
Program: *

Program: MSED Option #1 - Teacher Leader (33-hrs) MSED Option #2 - Principal (33-hrs) MSED Option #3 - Teacher Leader & Principal (42-hrs) PEP - Non-Degree Principal Only EDS - Specialist Degree in Education (33-hrs) None / Unsure
Course Requests: This form is ONLY for Off-Campus classes. If you are requesting an On-Campus class, you must self-register using the PAWS system at www.eiu.edu/paws
Class Request #1 ...
Class CRN ... (enter 00000 if not known):
Must be 5 digits. Currently Entered: 5 digits.
Students will find this number on the Course Schedule located on the Educational Leadership Website at www.eiu.edu/~edadmin, under Student Resources, Course Schedules & Registration Process.
Course *
Section *
Location *
Class Request #2 ...
Class CRN ... (enter 00000 if not known):
Must be 5 digits. Currently Entered: 5 digits.
Students will find this number on the Course Schedule located on the Educational Leadership Website at www.eiu.edu/~edadmin, under Student Resources, Course Schedules & Registration Process.
Course
Section
Location
Are you planning on utilizing any TUITION WAIVER(S) this term? *

Are you planning on utilizing any TUITION WAIVER(S) this term? No Yes ... please specify how many tuition credit hours you'll use & for which course(s)
AGREEMENT SIGNATURE/INITIAL:

By submitting this request, you agree to be enrolled for the selected class(es) above.

Please type your FULL NAME (or initials). *

EIU EDL -- Official Course Registration Form

EIU EDL -- Official Course Registration Form

Course Requests: This form is ONLY for Off-Campus classes. If you are requesting an On-Campus class, you must self-register using the PAWS system at www.eiu.edu/paws

Class Request #1 ...

Class Request #2 ...