Humboldt State University LogoHumboldt State University
College of Extended Education and Global Engagement

In partnership with the

North Coast School of Education

TEACHER INDUCTION PROGRAM
ACADEMIC CREDIT REGISTRATION FORM

If you would like to pay with a credit card (VISA, MC or Discover) or by electronic check,
please use this form to register for Teacher Induction classes.
Upon your submission of this form, you will be directed to the CASHNet online payment system,
where you will enter your credit card or electronic check information.

DO NOT USE THIS FORM FOR RETROACTIVE CREDIT

To request retroactive credit (for terms up to one year prior to the current term), please begin the process by contacting the NCTIP office at (707) 524-2818, during business hours. Allow up to four weeks for your request to be processed.

Student Information

* = Required field

Select your gender:

Have you ever been enrolled at Humboldt State University?*

Have you completed a Bachelor's Degree or higher?*

Secure Information

Please supply the following information: Social Security Number/HSU ID and Date of Birth
This information is submitted via SECURE SERVER, and is requested pursuant to Section 41201, Title 5, Calif. Code of Regulation and Section 6109 of the Internal Revenue Code.

Social Security Number or HSU ID ( - - ):* 
- -

Your date of birth is required so that Humboldt State University may identify records that are unique to you.

*
Course Credit Information

You are registering for credit for the following course.

Submit the form

Please check the box to confirm you are a human before you submit this form.
You may also be required to verify one or more Recaptcha images. Thank you for helping us prevent spam.

Please review the above information for accuracy before submitting this registration form.

Once you submit the form successfully, you will be directed to the payment system.




For more information, please contact the
College of Extended Education & Global Engagement
Humboldt State University
1 Harpst Street, Arcata, CA 95521  
•  Phone: 707-826-3731  •    •  Fax: 707-826-5885