CLARION UNIVERSITY OF PA

      

                                        Online Early Childhood Directors Credential Renewal Program

                                                        

                                                                   

 

Please complete the top portion of the form completely.  Use N/A for items that do not apply.   Items with an * are required entries. 
High School information is not required if applying to take a graduate level course.

This is a non-degree program and as a result, students are not eligible to receive financial aid.  If you are interested in pursuing an associate's or bachelor's degree program
at Clarion University, please complete the regular admissions process at www.clarion.edu/apply
Please visit http://www.clarion.edu/991 for information regarding applying to a
masterís degree program
.  Students seeking a degree may receive financial aid.

 

Last Name*:            First Name*:           Middle Initial:   

 

Former Names: 

 

Street Address*:             City*:           

 

State*:                     Zip*:                   Email Address: 

 

Birthdate*   (MM/DD/YYYY)       Sex*:          Race:   

 

Daytime Phone Number:          Home Phone Number*:     

 

PA Resident*:                 If yes, name of county:                

 

Degree Received*:    Bachelor's Degree
     Associate's Degree
     Master's Degree
     No Degree

 

Are you applying for Undergraduate or Graduate credit*:  Undergraduate
Graduate

 

Have you attended a college*:       

 

If you have attended another college,  College Name*:           

 

College GPA*      College Attendance Dates*  (MM/DD/YYYY) 

High School Attended*      High School Attendance Dates*  (MM/DD/YYYY) 

High School City and State*  

Received GED*:              If GED earned, date GED was received: 

Have you attended Clarion University previously?*    

Term for which you are applying*:    Spring   PreSession Summer I Summer II   Fall   Winter Intersession  

Year for which you are applying*:         
                                                    

Program you are applying for:  Early Childhood Directors Credential Renewal Program

How did you hear about the online Early Childhood Directors Credential Renewal Program ?

This form must be completed each semester of enrollment. 

Graduate students can only take up to two courses without formally applying on a non-degree or degree basis.

Applicants applying for graduate credits must submit an official transcript showing the bachelorís degree and date awarded
in a sealed envelope from the institution before being registered for the course
Please mail to Clarion University of PA,
Office of Graduate Programs, 840 Wood Street, Clarion, PA  16214

 

This form can only be used for the online Early Childhood Directors Credential Renewal Program.

 

By clicking the submit button, you are verifying that the information provided is accurate.