BMP Registration Form

Student Information

First

Last

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Phone

Please enter in the following format (# # #) # # # - # # # #

Confirm email

Course Selection

Please enter the information of the course(s) for which you would like to register. You may enter a maximum of three courses.

Course Schedule

Semester

Course Number and Title

Course Number and Title
Course Number and Title

(i.e. ET-640: Introduction to Islamic Law)

I am taking this course as

I have read and agree to abide by the following policies:

1. Submitting this form constitutes my formal enrollment in the listed course(s).

2. I must notify the Certificate Program Office of any withdrawals/course changes.

3. No refunds will be given after the second class session.

Math question 11 + 5 =

Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.