Content Course Reporting for Stipend Processing
Course Registration Host
*
UA Bursar
UA Outreach
Other in-state (ASU/NAU)
Out of State (submit leave of absence if no other UA registration)
NONE
Year
*
Please Select
2015
2016
2017
2018
2019
Semester
*
Spring
Summer
Fall
Please note that we can only pay for classes if you are registered with UA Bursars or Outreach
College, and have Dr. Olsen’s pre-approval
.
Contact information (please help us keep your contact info current)
First name
*
Last name
*
Street address
Street address line 2
City
State
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip code
School
*
Preferred phone number
*
Preferred email address
*
Course Number
Title
Units
Course number
Title
Units
In order to insure your tuition stipend is applied to your account in a timely manner and to avoid
late fees this form must be submitted before the beginning of the semester. It is your responsibility to make sure your tuition is paid in full. Contact Dr Olsen directly at 520.621.5682 or
jkolsen@email.arizona.edu
if you have any questions.
1501 E Speedway Blvd | P.O. Box 210069
Tucson, AZ | 85721-0069 | 520-621-5682 |
teachersinindustry.arizona.edu
|
tii@email.arizona.edu
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