CARMELITE STUDIES
DISTANCE EDUCATION PROGRAM
COURSE REGISTRATION FORM

(Please type or print)

Name _______________________________________ SSN ____________ Phone _____________________________

Address ______________________________________________________ Fax _______________________________

City/State ____________________________Zip Code __________ Email ___________________________________

___Lay, T.O.Carm.         ___Secular, O.C.D.S.       ___Diocesan       ___Other   _______________________________________________ 

Name of Religious Community __________________________________________________ Initials_____________

College/University Attended _____________________________Degree_________________ Year ______________

__ I am registering for the first time

__ I am interested in a Certificate in Carmelite Studies from WTU (credit) 

__ I am interested in a Certificate in Carmelite Studies from the Carmelite Institute (non-credit)

2008-2009 Academic Year: ___September 15 -January 15 (first semester)
or ___
February 15 -June 15 (second semester)

List the Course For Which You Are Registering:

_________________________________________________________________________________________________

• $200 partial or $800 total tuition payment for credit.

• $200 partial or $600 total tuition payment for non-credit.

• $30.00 first-time, non-refundable fee

• Letter stating purpose for studying courses, with the intent to obtain a certificate or to study courses independently.

• Make check(s) payable to: CARMELITE INSTITUTE

DISTANCE EDUCATION PROGRAM - CARMELITE INSTITUTE
Carmelite Institute 
Hecker Center, Suite #10
3025 4th Street, NE 
Washington, D.C. (USA) 20017-1102 
Voice: (202) 635-3534 § Fax: (202) 635-3538

E-mail: mail@carmeliteinstitute.org

www.carmeliteinstitute.org