USF Solutions – Continuing Education Programs Registration

Social Security Number: (999-99-9999) *

First Name: *

Last Name: *

Company Name:

Position title:

Company Address:

Birthdate: (MM/DD/YYYY) *

Gender? *
Male Female

Address: *

Address-2

City: *

State: *

Zip: *

Home Phone: (999-999-9999) *

Email Address: *

Please choose which class you would like to attend from the list below:
(If you are choosing more than 1 class, please fill out the form for each class chosen)

Understanding the College Search and Application Process – June 19, 2013- 6 p.m. – 8 p.m.- Free

Understanding the College Search and Application Process – July 10, 2013- 6 p.m. – 8 p.m.- Free

Understanding the College Search and Application Process – August 7, 2013- 6 p.m. – 8 p.m.- Free

The Older Adult and the Nurse (2.0 contact hours) – Online class – starts weekly – Fee: $30.00

Wellness for the Older Adult (6.0 contact hours) – Online class – starts weekly – Fee: $90.00

Helping the Older Adult Help Themselves (6.0 contact hours) – Start date: Online class – starts weekly – Fee: $90.00

The Older Adult and End of Life Concerns – Start date: Online class – starts weekly

Dementia Care – Online class – starts weekly – Fee: $45.00

Nursing/C.N.A. in Long Term Care (3.0 contact hours) – Online class – starts weekly – Fee: $45.00

Online Certificate in Franciscan Studies Course 1 – Start date: 9/23/13 – End date: 10/20/13 – Fee: $200.00

Online Certificate in Franciscan Studies Course 2 – Start date: 10/21/13 – End date: 11/17/13 – Fee: $200.00

Online Certificate in Franciscan Studies Course 3 – Start date: 1/6/14 – End date: 2/2/14 – Fee: $200.00

Online Certificate in Franciscan Studies Course 4 - Start date: 2/3/14 – End date: 3/2/14 – Fee: $200.00

Certificate in Grant Writing Four (4) Course Certificate Program - Online class – starts weekly – Fee: $340.00

Parent Enrichment Program (P.E.P) – Saturdays, Sept.7 – Oct. 12 – Fee: $75 person/$125 with guest for all five sessions

Introduction to Grant Writing - Online class – starts weekly – Fee: $85.00

Business Writing - Online class – starts weekly – Fee: $85.00

Professional Experience Supervision for Social Workers & Counselors (Wednesdays 5:30 to 7:30 p.m.) – Start date: June, September, February – Fee: $1,500.00

Professional Experience Supervision for Social Workers & Counselors (Thursdays 5:30 to 7:30 p.m.) – Start date: June, September, February – Fee: $1,500.00

Would you like more information on the University of St. Francis and its programs? Please check the boxes below:

YES, I am interested in Continuing Professional Education Credits (if applicable)

YES, I would like to receive future communications regarding USF Programs

• Typically, a 6 business day notice of cancellation is required for a full refund.
• Classes cancelled with less than 6 business day notice may be subject to a non-refundable textbook or cancellation fee (see class outlines for details, or contact us at 815-740-3600)
• No refunds are issued after the first day of class.

***YOU MUST PAY CLASS FEES BY CLICKING CONTINUE BELOW.
Your registration is not final until your fees are paid and validated***

If you have any issues with this form, please contact the Solutions Office at solutions@stfrancis.edu