Southeast Missouri State University

Southeast Missouri State University
Summer 2015 Application for Graduate Admissions / Advanced Placement Teacher Development Institute

This completed application and all application materials must be submitted by Friday, June 5, 2015.
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Application Checklist:
Submit this web form along with the following:
  1. $60.00 required Workshop Fee to cover on-site food (lunches and refreshments). You will be directed to pay this once you have submitted your registration information.
  2. Copy of driver's license, passport or birth certificate. Faxes are not always readable, so please mail or email scan/photo to gamick@semo.edu.
  3. 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
This completed application and all application materials must be submitted by Friday, June 5, 2015.

1.
Legal Name:
 
First Name:
Last Name:
 
Middle Name:
Former Last Name(s):
2.
Legal Address:
 
Street/P.O. Box:
 
City:
 
State/Region/Province:
 
Zip/Postal Code:
3.
Social Security Number:
Note: Your SSN is required to process this application.
- -
4.
Date of Birth:
5.
Summer Contact Email Address:
CONFIRM Summer Contact Email Address:
6.
School District Where You Teach:
 
School District:
 
School Name:
 
School Phone:
(-
 
School Street/P.O. Box:
 
School City:
 
School State:
 
School Zip/Postal Code:
 
School Email Address:
 
Billing Contact's Name:
 
Billing Contact's Email Address:

7.
Please select the institute for which you are applying:
ALL institutes will be held July 13th - 17th, 2015 at Hazelwood West High School in Hazelwood, MO.
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 slot becomes available. If you have any questions, please contact our office at 573-651-6179.
 
Select
Institute
Seats Available
 
Biology
7
 
Calculus AB
Waiting List
 
Chemistry
4
 
English Language and Composition
4
 
English Literature and Composition
Waiting List
 
French Language and Culture
23
 
Psychology
12
 
Studio Art 2-D Design
19
 
U.S. Government & Politics
3
 
U.S. History
25

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