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External Degree Request for Course Registration
Institute for Experiential Learning (IEXL)

NOTE: This request to register form is for the onsite Institute for Experiential Learning (IEXL) courses only. These courses will be held on the Fayette campus and attendance for the full week is required.

Full Name:
Social Security Number:
Address:
     City:
     State:
     ZIP:
E-mail:
Home telephone number:
Work telephone number:
 
Department Course
Number 		Course Title

PAYMENT

Tuition is $795 for each three-credit course. Payment is due at the time of registration either by check or credit card.

I will be making payment by:

Use of financial aid

Sending a check

Company tuition assistance

Military tuition assistance

If you would like to make payment now, you may due so by entering your MasterCard or Visa credit card information on this secure form below.

Charge Registration Fee to:
Name on Card:
Credit Card Number:
- - -
Expiration Month:
Expiration Year:
Card Security Code:

                     

Questions?

External Degree Office
Upper Iowa University
P.O. Box 1861
Fayette, Iowa 52142
Phone: 1-888-877-3742
Fax: 1-563-425-5353
E-mail: extdegree@uiu.edu