Individual Course Registration Form - Web2010
SAVE THIS FORM TO YOUR COMPUTER FIRST.
Then, fill it out and send it to CALCampus by fax or surface mail. Or you may phone in your credit card information. Do not e-mail credit card information.
For CALCampus Administrative Use:
Date_____________ Student Name: Mr._______ Ms._______
First Name:_____________________ Middle Initial:____ Last/Family/Surname:______________________
(as should appear on transcript)
Date of birth (optional)_____________________If under 18, check here _________
Internet E-mail_____________________________ Phone___________________ Fax_____________
Student's Mailing Address________________________________________________________
_________________________________________________________________________________
Upon completion of a course, one free official transcript, signed and sealed with grade, is mailed to your desired location. Include NAME and ADDRESS where transcript is to be sent. If to a school, we require the Name of the Department, Name of Contact Person, and complete Address.:
___________________________________________
___________________________________________
___________________________________________
(Subsequent course transcripts must be requested separately in writing to Registrar and cost $25.)
====================================================================== COURSE REGISTRATION
See Course List for Course Titles and Prices.
(check one): New Student____ Current/Former CALCampus Student____
New Student Admission Fee: $50 (pay one time for a new student)
Course Title _______________________________________________________
Course Number ___________
NEW STUDENT ADMISSION FEE ($50) (if a new student) + COURSE REGISTRATION FEE ($______) = TOTAL $___________________
===================================================================== STUDENT ACKNOWLEDGMENT
Required reading. Confirm that you have received the information below. Check below:
____ I have read this course registration form, the relevant course description posted online, the refund policy, and have downloaded the Student Manual. If seeking college credit, I have read college credit info. If seeking high school credit, I have read high school credit info.
Signature of Student ___________________________________________
====================================================================== PAYMENT METHOD (Select one.) Amounts in U.S. funds.
Check/Money Order _____ See instructions below.
Credit Card Check one. Credit cards are billed by the CALCampus
VISA___ MasterCard___ Discover___ American Express___ Diners Club___
Debit VISA___ Debit MasterCard___
Card #__________________________________________________
Expiration Date of Card ____________
CVV Code (VISA/Mastercard/Discover 3-digit # on back of card) ___________
CID Code (AmEx 4-digit # on front of card) _______________
Name of Card Owner_______________________________________________________
If card owner is not the student, state relation to student________________________________
Billing Address of Card Owner
(if different than student's address)_______________________________________________________
Phone Number_____________________________E-mail______________________________
Signature of Card Owner____________________________________________________
========================================================== REASON for taking course.
College Credit___ High School Credit___ Home School Credit___
Professional Dev___ General Review___ Job Requirement___ Personal/Just For Fun___
High School Prerequisite for College or Job ____ Other_____
If for use at a college or high school, please specify name of school. Thank you.
_________________________________________________________________________________
If for use at your school, please provide your counselor/advisor's name and e-mail address, if available.
_________________________________________________________________________________
If taking a course for transfer into another school or for an organization, check with them
to get approval, preferably in writing, before registering. The decision to accept a course from
any other school is always made by the receiving institution.
Courses take 12 weeks. Can you commit 12 weeks to this course?_______________
Where did you hear about our school?______________________________________________
If by search engine, which one?_________________________________________________
Other Comments_______________________________________________________
___________________________________________________________________________________
========================================================
INSTRUCTIONS FOR CALCAMPUS COURSE REGISTRATION
Note: Students start their courses AFTER their registration form and
payment have been received and processed. Fill out one form for each course please.
You may pay by check/money order in US dollars payable to CALCAMPUS or by credit card.
Credit cards are billed by CALCampus. International students
paying by check should go their bank and get a bank check in US dollars. You may register by
surface mail, fax, or e-mail.
To register by SURFACE MAIL, print this Registration Form, fill it in, sign, and mail with payment to
To register by FAX, print this form, fill it in, sign, and fax it to the number at the top of this form.
CALCampus Student Admission Fee is non-refundable after three days.
CALCAMPUS HONOR CODE
Each student is required to do his/her own work in all homework assignments, projects, and
exams. Answers to questions are to be written in your own words so that instructors
can determine that you indeed understand the information you are studying. Copying verbatim from
an instructional source or from others (unless specifically requested by the parameters of the
assignment and with appropriate citation of sources used) is not acceptable and is grounds for
administrative removal from course enrollment with no refund.
TO DROP AN INDIVIDUAL COURSE WITH A REFUND
Any buyer may cancel this transaction any time prior to midnight of the third business day after the date of this transaction. All monies paid by the student, minus a $25 drop fee, will be refunded if requested before midnight of the third business day after you submit the course registration form. The drop request is to be sent to the Registrar in writing and may be submitted by e-mail, fax, or surface mail (postal date is considered date of request). The Registrar will acknowledge receipt by e-mail; if you do not receive an e-mailed acknowledgment, we have not received your request and you should call us. In the event that you wish to drop a course after three days, you must contact the Registrar WITHIN ONE WEEK (7 days) from the date when your official CONFIRMATION LETTER was dated and BEFORE you download any online course materials from CALCampus. If you do this, you will receive a full refund of your course registration fee (not the student admission fee, which is not refundable after 3 days) minus a refund processing fee of $25. For more details for New Hampshire students, see
New Hampshire Residents Refund Policy.
CALCampus does not guarantee employment upon completion of any of its programs; nor do we claim to be any type of employment agency.
COMPLETION TIME, COURSE REACTIVATIONS, COURSE REREGISTRATION
Courses are designed for completion in 12 weeks, doing one lesson per week and
allowing time for course startup, weekly assignments, comments from teacher on assignments, midterms, finals, and projects. The official starting date of
your course begins when you receive your Course Confirmation letter from the Registrar.
Plan ahead and allow 10 weekdays for processing your final grade and your transcript.
To anticipate unexpected longterm delays, CALCampus will allow you to complete the course within six months from the date of course confirmation. After that date, you will need to request a reactivation and extension of the particular course and get approval from the Registrar and the instructor. If approved, the course reactivation costs $50 for a three-month period. Two three-month reactivations per course are allowed over a total of 12 months from the original course confirmation date. After 12 months from the time of original course confirmation, the student must submit a new registration form and full payment for the course as posted on the current course list. Contact the Registrar for more details, should you have questions.
CALCampus will contact you through e-mail with confirmation of your Admission and Course
Registration within 1-2 business days of receipt of your registration and payment. If you
don't hear from the Registrar within 48 hours, please e-mail or call us. Thank you for your support.
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