Continuing Teacher Education Application

Round

Instructions

This application is for DESIGNATED APPLICANTS only.

Applicants must have received instructions to use this application and the 5000 level course numbers directly from the K12 programs under the College of Education. If you have not been instructed to use this form, go out of the application and select the correct undergraduate or graduate application. Unauthorized users will be charged an application fee, full tuition, student fees, and course fees.

Please allow one business day after submitting the application to register for the course(s) with the course numbers provided by your District of the SUU K-12 office.

If you have questions or need assistance, contact the SUU K-12 Program at k12inservice@suu.edu or 435-865-8085.

Personal Information

First/Given Name

Last/Family Name

Mailing Address

Country

Street

City

Region

Postal Code

Email Address

Phone Number

Birthdate

Sex assigned at birth for state and federal reporting

Are you Hispanic or of Latino Descent

Yes

No

Race

What is your citizenship status?

Social Security Number

What is your visa type?

You must provide a copy of your passport to the Admissions Office by email to ADMISSIONS@SUU.EDU, fax to 435-865-8223, or mail to

SUU Admissions Office
351 W University Blvd
Cedar City, UT 84720

What term you would like to take classes?

Application Term

Student Type

Continuing Education Program

Campus

Educational History

Enter previous school(s) attended

Level of Study

School CEEB

Start date (mm/dd/yyyy)

End date (mm/dd/yyyy)

Privacy Act Notice:

The University confidentially maintains your personal information including birthdate and Social Security Number(SSN) or Individual Taxpayer Identification Number(ITIN) for routine uses such as, facilitating document matching, verifying your identity, and expediting your enrollment and financial aid. Disclosure of your SSN or ITIN is voluntary, but failure to provide your birthdate and/or SSN or ITIN may result in confusion regarding your identity, and once admitted, could result in delay or loss of federal and state financial aid, tax credits, student loan deferments, veteran benefits, and other benefits under law. If you do not wish to disclose your SSN or ITIN number on this form, or if you do not have an SSN or ITIN number, enter "1" in that field.

Clery Act:

Each year SUU’s Police Department publishes an Annual Security & Fire Safety Report (ASR/AFSR) with updated crime statistics and information intended to inform the SUU community, including prospective students, about the institution’s safety- and security-related policies, procedures, and programs. SUU is required by law to share this important information with you. You can download the most recent version of our Annual Security & Fire Safety Report at https://www.suu.edu/clery/. You may also request a paper copy of this report from the SUU Police Department by visiting their offices at 36 N. 300 W., Cedar City, UT 84720 or by calling (435) 586-7793.

Southern Utah University is required by federal regulations to distribute our Drug and Alcohol Abuse Prevention Program (DAAPP) Disclosure to all students and employees. Please review with careful consideration. You can find and download a copy of the SUU DAAPP Disclosure athttps://www.suu.edu/health/daapp/.

Generate Pin

Yes

No

App Submitted Flag

Yes

No

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