Continuing Education Registration Form
This form should be used if the course is no longer available for online registration.
First Name
Last Name
Email
NetID
Date of Birth
Street Address
City
Zip
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Phone Number
Gender
Please select...
Male
Female
Decline to state
Program
Please select...
California State Notary Public Training
Certificate in Art Museum and Gallery Studies
Certificate in Chemical Dependency Studies
Certificate in Construction Management
Certificate in EKG Technician
Certificate in Human Resource Management
Certificate in International Business
Certificate in Medical Billing and Coding
Certificate in Nonprofit Management
Certificate in Paralegal Studies
Certificate in Project Management
Certificate in Social Media Marketing
Certificate in Wedding Planner
Government Agile Certification
HR Certification Preparation Course
Online Continuing Education for Teachers
Speech-Language Pathology Assistant Program
Term
Please select...
Fall
Spring
Summer
Course Start Date
Course Number
Course Section
Course Title
Add another course?
Yes
No
Course Start Date
Course Number
Course Section
Course Title
Add another course?
Yes
No
Course Start Date
Course Number
Course Section
Course Title
Add another course?
Yes
No
Course Start Date
Course Number
Course Section
Course Title
For details about our Withdrawal and Refund Policy, visit our
Registration Policies website
.
We will contact you when your registration form has been received, and payment will be due at that time. Payment must be received in full for enrollment to be valid.
Failure to pay fees within 48 hours of enrollment will result in being dropped from courses.
Please indicate your intended payment option below.
Personal check or money order payable to CSUEB
Online payment by credit card or electronic check
Paid by employer
Third Party Payment (WIA, DOR, AmeriCorps, etc.)