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March 2011 MBA ONLINE Registration Fonn
Student ID #: Birth date 09/25/ 1972 2Male - Female
MonthlDatelYear
Name: __ __ _ ______________ E_GE_L
Last First Middle Initial
Address 10407 Magnolia Blvd. # 2 1 2 Tol u ca Terrace, CA 916 01
Street City 818-76 0- 81 03 State Zip
__ -_2_6_3 -_3_ __________ __ __________ 8_1_8__ __ 0_9_5
Daytime Evening E-Mail (Mandatory)
New Address? =yes }c no Have you been previously enrolled At CSUDH? 2C yes
no
Instructions' Please CIRCLE course(s) in which ARE. enrolling. If unmarked, the form cannot be processed.
1. 30463 ACC 502 41 3 $1320
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-......... Human Behavior in Organizations
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3. 30462 500 41 3 $1320
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'-- ______ ______________________________________
4. 30465 FIN 503 41 3 $1320
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International Finance MMch 30
th
- June 22
nd
(Finance concentration, Internati onal Business or an elective for General Business)
5. 30464 CIS 550 41 3 $1320
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Project MMch 30
th
- June 22
nd
(IT concentration QI. an elective for General Busi ness)
6. 30467 HRM 520 41 3 $1320
('Ot 111
Essentials of Human Resources MMch 30
th
- June 22
00
(Management concentration QL an electi ve for General Bllsiness)
7. 30466 501 41 3 $1320
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Information MMch 30
th
- June 22
nd
(Marketing QI. an electi ve for General Busi ness)
Check/Money Order Made Payable to CSUDH
Course(s) Fee: _ VISlTOR
I AUTHORIZE THE USE OF MY: 1VISA -MASTERCARD :: DISCOVER
$25 Late Fee*: ::: FINANCIAL AID
4264 6555 25 6 3 5813 Total Fee Paid:
$2 64 0
EXPIRATION DATE ACCOUNT NUMBER#
*Regular course fees apply until 30, 2011. Between March 31, 2011 and April 7' 2011, you will be charged the late fee. After April 8,
2011 the registration will be invalidated. No exceptions.
Please return by FAX (preferred) or EMAIL: Mail checks to: MBA OnJine Office
FAX: Online Office (310) 516-4178 CSUDH 1000 E. Victoria St. Carson, CA 90747
crvan @csudh.edu
REFUND POLICY (please read and sign below): Refunds are granted In accordance wnh the State refund schedul e. If a CO urse IS cancelled, the enllre course fee w!ll
be returned. If you withdraw 24 hours prior to the fIrst class meeting, 100 percent of the course fee will be refunded (less a $10 processing fee) . If you withdraw after the
fI rst class and before 25 percent of the course have elapsed, 6S percent of the total fee will be refunded, After 2S percent of the course time has elapsed, no refund will be
made, however, a drop form must still be tiled. Stop payments on checks are NOT an acceptable withdrawal from the course(s) and will result in a financial penalty. I
u de ' d the rules reg'k?.Jre ref nd policy and I authorize 'jJ;J.iJ[d!JWr above.