THIS IS AN OFFICIAL ENROLLMENT FORM FOR UMKC GRADUATE CREDIT

By submitting this form, you have read, understood and agree to follow CE/UMKC policy stated on form and CE/UMKC website.

Please PRINT and Complete ALL Sections

UMKC Continuing Education Enrollment -- School of Education -- (816) 235-1188

(Illegible forms or failure to complete all sections will result in enrollment delays.)

Date ______Name ______UMKC Student ID: ______

(Last) (First) (Middle) (Prior)

Address ______

(Number & Street) (City) (State) (Zip) (County)

Phone (______) ______(______) ______(______) ______

(Home) (Work) (Cell)

E-mail Address ______E-mail Address #2 ______

Required- we will contact you via email

Date of Birth ______School District ______

(Month) (Day) (Year)

Yrs. In District _____ Yrs. Teaching ______Less than one year teaching: Yes No

Gender:  Female  Male

In an effort to better serve our student population, design programming that is more inclusive, and remains compliant with federal, state, local, and several granting organizations, please indicate your ethnic or racial background. Please select all that apply and indicate primary by circling it:

Are you Hispanic/Latino? Yes No

American Indian / Native Alaskan Asian (underrepresented) Black/African American White Non-Hispanic

Asian (includes Chinese, Filipino, Japanese, Korean, Asian Indian or Thai)  Native Hawaiian or other Pacific Islander

Student Level

Highest degree earned ______Year If still undergraduate, # hours earned? ______

UMKC Record

Enrolled in other UMKC courses this term? Yes No Prior UMKC credit? Yes No If yes, what year?______

Residency Status

Missouri resident? Yes No Place of birth: City______Length of MO residency? ______

Previous legal address, if less than one year in Missouri: ______

City______State ______

Are you a legal resident of Johnson, Leavenworth, Miami or Wyandotte county in KS? Yes No

US citizen? Yes No If no, country of citizenship: ______Visa type______

(Students with F-1 and J-1 visa status are not eligible for part-time or Missouri Taxpayer Scholarships. These students should call the Cashiers Office at 235-1365 for fee information.)

If resident alien: Card number ______Date of issue ______

Attach a copy of your card. If you are an international student (nonresident alien), contact the International Student Affairs Office before completing this form. You will need to provide a copy of your VISA, passport and I-94 documentation.

Students must be in good standing with the University to take any class.

Class # / Term / Course # / Sec# / Cr Hr / Course Title/Subtitle
47815 / FS11 / EDUC 489T / 0058 / 1 / Special Topics: The Chemistry of the Body – Science Pioneers

$ 50.00 total for class

Note: If this class is online, contact your instructor for log in information. To find out your UMKC sign on once you are enrolled, contact Information Systems at 816.235.2000.

University of Missouri-Kansas City Enroll by fax or email:

School of Education—CE, Room 24 Fax: (816) 235-1614

5100 Rockhill Road Internet: http://www.umkc.edu/education/ContinuingEducation

Kansas City, MO 64110-2499 Email to:

Keep For Your Records

Enrolling for UMKC Graduate Credit – School of Education/Continuing Education

The current guidelines may change without notice.

Course Syllabus - The syllabus for this course was reviewed by UMKC to approve the course for graduate credit. The syllabus includes specific requirements/criteria for final grades and a final due date for course work. Please keep a copy of the syllabus for your records. If you are using this course for recertification purposes, please retain a copy of the course syllabus in your files so you can present full course information if required. Please note that all Continuing Education courses are listed as Special Topics on a transcript, so your syllabus will differentiate this course from others. Contact your instructor for a copy of the syllabus.

ENROLLMENT - Educators who want to earn UMKC graduate credit as part of the course must complete and submit to CE the enrollment form before the end of the first class meeting. An enrollment receipt will be e-mailed to each participant after the enrollment is processed in CE. If no email address is provided, no enrollment receipt will be sent. Any holds on the student’s university account will delay or prevent enrollment. It is the student’s responsibility to resolve any holds. NO ENROLLMENTS WILL BE ACCEPTED AFTER THE DEADLINE!

PAYMENT - CE cannot accept payment. You can pay online after enrollment is entered (approximately one week from date CE receives the enrollment) at http://www.umkc.edu/adminfinance/finance/cashiers/default.asp.You will receive a bill in the mail unless you sign up for electronic billing through Pathway. Call the Cashier with payment questions at 816-235-1365. You will need your student number when paying online. If you have questions on obtaining your student number, call Registration at 816-235-1125. (Due to student privacy issues, CE cannot give out student numbers over the phone.)

Nonresident tuition is due only if you enroll in more than six hours for fall, winter or intersession terms or more than three hours in the summer. If hours exceed those maximums, nonresident fees are charged on all hours. If you pay Missouri income tax, nonresident tuition is waived by providing your most recent MO tax return and form to the Cashier's Office.

TO DROP A CLASS: If you decide to drop the class, the student must notify CE in writing (email is acceptable) immediately. Just letting your instructor know is not sufficient. UMKC will not refund any tuition after the class has started. There are no refunds for continuing education classes lasting fewer than three days. No refunds are given for ASCD online classes once a login is created (one week prior to start of class). If you wait till after the end of the UMKC semester to drop a course, a ‘W’ is posted to your transcript and NO refund is given. Payment will still be required. Withdrawals are not permitted after a semester has ended and payment will still be required. Even with instructor consent, no enrollments are accepted three weeks prior to end of the UMKC semester.

Grades and Transcripts

All course work must be completed by the due date assigned by the instructor(s). Incomplete coursework will result in a grade of (F) or Incomplete (I). Note that incomplete (I) grades automatically become (F)s after one year. Only the course instructor may request a grade change and accept late course work.

Final grades will be available from the University system soon AFTER the end of each semester.

The semester calendar is on the UMKC website at www.umkc.edu/calendar. They are no longer mailed to students. Grades are available on the Web at www.umkc.edu/registrar/.

Transcripts are available for a nominal fee, and you may request a copy be mailed to your employer/school district. Visit http://www.umkc.edu/registrar/forms/transcript_request.pdf for the necessary form for requesting a transcript. Please fill out the form completely. You can request a transcript in person, by mail, or by fax because a signature is required. Requests are handled on a first-come, first-serve basis. Please allow extra time for mail delivery.

·  To request a transcript in person, go to 5115 Oak Street, room 115.

·  To request a transcript by mail, submit a request form to UMKC Transcripts, 5100 Rockhill Rd. KCMO 64110.

QUESTIONS? Payments – Cashier’s: 816-235-1365

Transcripts – Transcript Office: 816-235-1122

UMKC Log in – Information Systems: 816-235-2000

Student No., PINS, Grades – Registration: 816-235-1125

Enrollment forms, DROP CREDIT, other questions – CE: 816-235-1188