Graduate Registration Form

1. Course Number & Title:
2. Name: First: Last:
3.Home Phone: - -
4.Work Phone: - -
5. Address: Street:
City: State: Zip:
6. Have you EVER taken a WCU course? yes no
7.Gender: Male Female
8.WCU ID:
If you do not know your ID #, or if this is your first WCU course, enter 0000000
9.Date of Birth: Month: Day: Year:
10. Residence County:
11. Citizenship Country:
12. Cell Phone: - -
13. Email Address:
Please include a regularly accessed e-mail for purposes of confirmation and contact with instructors.
14. Grade(s) Level presently taught:
15. Job Title:
16. School District:
17. Building:

Costs:

Three-credit course is $1,389
One-credit course is $463
Out-of-state residents pay higher fee
Add $50 materials/facility fee for Visualizing Words and Worlds courses
PAWLP Fellows can receive a $200 stipend to reduce tuition for one three-credit course each session.

 Check here if you are a PAWLP Fellow
Institute Location and Year

 
Payment Methods
18. Check or money order #:
19. Check amount.
Your phone number should be on your check or money order. Make check payable to West Chester University.
 
20.Credit card: The University accepts Mastercard, Discover, and American Express. Credit card payments must be made on-line at myWCU and are subject to a 2.75% fee.

Please check here if you will pay on-line by credit card.
You must be registered for the course before you can pay on-line.
 
For more information, call 610-436-2202
Visit the PAWLP Website http://www.pawlp.org