Summer 2018 Application for Graduate Admissions / Advanced Placement Teacher Development Institute
If you previously started an application please use the "Login Here" button to continue.
This completed application and all materials must be submitted by Friday, June 8, 2018
Page 1 of 3
Application Checklist:
Submit this web form along with the following:
 a. $90.00 required Registration and Program Fee. You will be directed to pay this after you have submitted your registration information.
 b. Copy of driver's license, passport, birth certificate, or green card must be uploaded on page 3 of this application.
 c. Advanced Placement Teacher Development Institutes Approval Form

All documents should be mailed directly to:
Southeast Missouri State University
Office of Admissions
MS 3550
Cape Girardeau, MO 63701
Legal Name:
First Name:   Last Name:  
Middle Name: Former Last Name(s):
Legal Address:
Street /P.O. Box:   City:  
State:   Zip Code:  
Social Security Number:  
Date of Birth
Summer Contact Email Address:  
CONFIRM Summer Contact Email Address:    

School District Where You Teach
School District:  
School Name:   School Phone: ( )    -  
School Street/P.O. Box:   School City:  
School State:   School Zip Code:  
School Email:  
Billing Contact's Name:  
Billing Contact's Email:  

Please select the institute for which you are applying:
If "Seats Available" indicates "Waiting List", please complete the registration process. You are not guaranteed a slot, but will be assigned
one if one becomes available. You will be contacted via email if a seat becomes available. If you have any questions, please contact our
office at 573-986-6179