Registration Form 2016-2017. Please provide a COMPLETE mailing address to receive confirmation. ... Register by mail, fa
Certificate in Non-Profit Management Registration Form 2016-2017 Please provide a COMPLETE mailing address to receive confirmation.
Name __________________________________________
Title ______________________________
Name as preferred on certificate
Organization Name ____________________________________________________________________ Organization Address _________________________________________________________________ Street or P.O. Box
_________________________________________________________________ City
State
Zip
Home Address _______________________________________________________________________ Street or P.O. Box
_______________________________________________________________________ City
Mobile Phone__________________
State
Work __________________
Zip
Home _____________________
Email ________________________________________________________________________________ Do you have any food allergies or restrictions? _____ If so, please list: ___________________________ ______________________________________________________________________________________ Please list any medical issues of which we need to be aware? __________________________________ Course Fee: In-State (SC) Tuition- $425, Out-of-State Tuition-$525 (includes tuition, materials, and lunches. Can be paid in 2 equal installments of $212.50 each for In-State and $262.50 for Out-of-State.)
Payment: Payment will only be processed if accepted into the program. Amount: _________ Check # __________ (payable to Winthrop University Institute of Management) MasterCard __ Visa __ Card Number___________________________________ Exp. Date __________ Security Code: _________ Register by mail, fax, or phone. Send registration form to: Celeste Tiller, Director, The Institute of Management, Winthrop University, 213 Thurmond Building, Rock Hill, SC 29733 Phone 803/323-2409 or FAX 803/323-2539 *If a cancellation notice is received one week prior to the start of class a cancellation fee of ½ the course fee will be charged. There will be no refunds for registrants who fail to show up to class. Substitutions are allowed.
