Salutation Mr. Mrs. Ms. Dr. Prof.

First Name

Last Name

Email

Phone

Billing Address One

Billing Address Two

Billing City

Billing State

Billing Zip Code

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Institution

Job Title

Which most closely describes your role within your organization? Administrator (e.g. President, Provost) Faculty Leader (e.g. Dean, Dept. Chair, Director of Center for Teaching/Learning) Faculty Member Other

In which course would you like to enroll first? Creating a Productive Learning Environment Creating a Productive Online Learning Environment Promoting Active Learning Promoting Active Learning Online Inspiring Inquiry and Preparing Lifelong Learners Inspiring Inquiry and Lifelong Learning in Your Online Course Designing Learner-Centered Courses

Which date would you like to begin first course? August 2, 2025 October 4, 2025 January 24, 2026 March 28, 2026 May 30, 2026 August 1, 2026 October 3, 226 January 23, 2027 March 27, 2027

Will you be teaching at the time of the first course? YesNo

In which course would you like to enroll second? Creating a Productive Learning Environment Creating a Productive Online Learning Environment Promoting Active Learning Promoting Active Learning Online Inspiring Inquiring and Preparing Lifelong Learners Inspiring Inquiry and Lifelong Learning in Your Online Course Designing Learner-Centered Courses

Which date would you like to begin second course? August 2, 2025 October 4, 2025 January 24, 2026 March 28, 2026 May 30, 2026 August 1, 2026 October 3, 2026 January 23, 2027 March 27, 2027

In which course would you like to enroll third? Creating a Productive Learning Environment Creating a Productive Online Learning Environment Promoting Active Learning Promoting Active Learning Online Inspiring Inquiring and Preparing Lifelong Learners Inspiring Inquiry and Lifelong Learning in Your Online Course Designing Learner-Centered Courses

Which date would you like to begin third course? August 2, 2025 October 4, 2025 January 24, 2026 March 28, 2026 May 30, 2026 August 1, 2026 October 3, 2026 January 23, 2027 March 27, 2027

How will you be paying your enrollment fee? My institution will pay for my enrollment.I will use personal funds.

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