Salutation Mr. Mrs. Ms. Dr. Prof.

First Name

Last Name

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Phone

Billing Address One

Billing Address Two

Billing City

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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? January 26, 2026 March 30, 2026 June 1, 2026 August 24, 2026 October 19, 2026 January 25, 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? January 26, 2026 March 30, 2026 June 1, 2026 August 24, 2026 October 19, 2026 January 25, 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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