Salve Regina Graduate Studies - Continuing Education: COURSE REGISTRATION

CONTINUING EDUCATION: COURSE REGISTRATION

* Required Fields

First Name: *

MI:

Last Name: *

Telephone Number: *

FAX Number:

E-Mail: *

Maiden Name:

Gender: *

Address: *

City: *

State: *

Zip: *

Social Security#:

Date of Birth: *

- Please complete all fields for each course you wish to register.

Veteran Benefits: *

Financial Aid Recipient: *

If yes, what type?

Have you taken extension courses at Salve before: *

How many?

Select one of the following, for the US Government:

Select your payment option:
Payment options require Visa/Mastercard information below.

Full payment of tuition and fees.
Third Party Tuition Reimbursement, such as payment by employers. Fax immediately the third party documentation to the Registrar at 401-341-2996. (We will charge your card the portion not covered by your employer plus the $40.00 registration fee.)
Military Tuition Assistance Fax immediately the T.A. documentation to the Registrar at 401-341-2926. (We will charge your card the portion not covered by T.A. plus the $40.00 registration fee.)
Financial Aid (Loans) The option requires no immediate charge to your Visa/MasterCard information below.