WCTP 602: Getting Started with National Boards – Registration Application

Academic Year*

Component(s) Completing This Year*

Component 1
Component 2
Component 3
Component 4

Personal Information

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Candidate Status*

Do you have any additional cadidate support help?*

Yes
No

Who is your candidate support help?*

How did you hear about us?*

Professional Information

School District*

School Name*

Program Information

Which Certificate are you Applying For?*

UM WCTP 602 Participation Terms

WCTP Participation Terms Agreement*

ALL PARTICIPATION TERMS MUST BE MET prior to receiving candidate support from the WCTP.

I understand this is an independent, self-paced course.
I have paid the annual, nonrefundable $135 enrollment fee.
I understand this course is owned by the University of Mississippi and sharing of passwords or course resources is unethical and will result in removement from the course.
I understand enrollment ends August 1 of my selected cycle year.

Electronic Signature

Typing your name below will serve as your official signature on your application to the University of Mississippi World Class Teaching Program's 602 course.

Electronic Signature*