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College of Extended Education and Global Engagement

In partnership with the

North Coast School of Education

NCSOE Coursework
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 purchase credit for NCSOE coursework.
Upon your submission of this form, you will be directed to the payment portal,
where you will enter your credit card or electronic check information.

PLEASE DO NOT USE THIS FORM FOR RETROACTIVE CREDIT

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

Student Information

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Select your gender:

Have you ever been enrolled at Cal Poly Humboldt?

Have you completed a Bachelor's Degree or higher?

Secure Information

Please supply the following information: Social Security Number/Humboldt 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 Humboldt ID ( - - ): 
- -

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

Course Credit Information

You are registering for credit for the following course.

Submit the form

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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 portal.