REGISTRATION: Tri Valley

Tri Valley Teacher Induction Registration

Step 1 of 2 - General Information

Personal Information

Name(Required)

First Middle Last

Previous Names Used (If Applicable)

Phone(Required)

Work Phone

Email(Required)

Work Email

Last 4 of SSN(Required)

Date of Birth(Required)

Highest Degree Earned(Required)

Name of College/University where you earned your highest degree(Required)

District(Required)

Have you previously taken courses with Courses4Teachers?

Yes

Have you previously taken courses with University of the Pacific?(Required)

Yes

Academic Year of Program Completion(Required)

Course Registration (select all that apply)

Select the modules you would like to receive credit for below. Each Module earns you 4 units and costs $200.00

PEDU 9247 Teacher Induction I

4 units

PEDU 9248 Teacher Induction II

4 units

Order Summary

Course(s)	Credit(s)	Credit Price	Credit Fixed Price	Total
Grand Total

Attach Proof of Completion if Required

Max. file size: 512 MB.

Payment Information

Please provide your credit card information below. *Credit card fields will only appear once the address has been entered and charge authorization box has been checked.

Address(Required)

Order Summary

Course(s)	Credit(s)	Credit Price	Credit Fixed Price	Total
Grand Total

Charge Authorization(Required)

I, hereby, authorize University of the Pacific to charge my credit card for the total listed above.

Post-baccalaureate semester units of credit from University of the Pacific, Center for Professional & Continuing Education. Professional Development Courses are for graduate participants who are NOT pursuing an advanced degree at University of the Pacific. Acceptable where local districts approve and applicable to state licensing where authorized.
Tuition fees are nonrefundable. University of the Pacific is fully accredited by WASC.

Payment

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CVC

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Comments

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Tri Valley Teacher Induction Registration

Personal Information

Course Registration (select all that apply)

Payment Information

1812 W. Burbank Blvd, #1031 Burbank, CA 91506

1812 W. Burbank Blvd, #1031
Burbank, CA 91506