EIU EDL -- Course Waitlist Request Form

Utilize this form to request to be waitlist enrolled into a course offered outside your usual cohort, etc.

Semester: *
Year: *
E-Number: *
Name: Name: * First Last
Address: Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Cell Phone: Cell Phone: * - ### - ### ####
EIU Email: *
Home Email: *
Work Email:
On- or Off-Campus cohort member: *
Program: *

Program: MSED Option #1 - Teacher Leader (33-hrs) MSED Option #2 - Principal (33-hrs) MSED Option #3 - Teacher Leader & Principal (42-hrs) PEP - Non-Degree Principal Only EDS - Specialist Degree in Education (33-hrs) None / Unsure
Waitlist Course Request (complete one form for each class you wish to waitlist into): This form is ONLY for Off-Campus classes. If you are requesting an On-Campus class, you must self-register using the PAWS system at www.eiu.edu/paws
Waitlist Course Request ...
Class CRN ... (enter 00000 if not known):
Must be 5 digits. Currently Entered: 5 digits.
Students will find this number on the Course Schedule located on the Educational Leadership Website at www.eiu.edu/~edadmin, under Student Resources, Course Schedules & Registration Process.
Course *
Section *
Location *
Are you planning on utilizing a TUITION WAIVER? *

Are you planning on utilizing a TUITION WAIVER? No Yes ... please specify how many tuition credit hours you'll utilize
AGREEMENT SIGNATURE/INITIAL:

By submitting this request, I agree to be waitlisted for the selected class above. I also understand that established cohort members have first priority for registration, and that my enrollment is not guaranteed.

Please type your FULL NAME (or initials). *

EIU EDL -- Course Waitlist Request Form

EIU EDL -- Course Waitlist Request Form

Waitlist Course Request (complete one form for each class you wish to waitlist into): This form is ONLY for Off-Campus classes. If you are requesting an On-Campus class, you must self-register using the PAWS system at www.eiu.edu/paws

Waitlist Course Request ...