CCE 150 Intensive Registration – Asbury University

This form is to be completed only by students requesting late registration for the CCE150 intensive course, Cultural Engagement and Responsibility (1 credit hour).

Name*

First Middle Last

Email*

Student ID Number*

Grade Level*

Freshman
Sophomore
Junior
Senior

Expected graduation date*

Intensive section desired*

Please acknowledge*

I understand in order for this course to be satisfactorily completed, I must attend ALL days/times for this intensive section.

Please acknowledge*

I understand if this added course moves me to a new tuition bracket (i.e. from 12 to 13 or from 18 to 19 hours), my student account will reflect this increase in tuition.

Credit Hours Currently Enrolled*

Please acknowledge*

I understand I am expected to purchase the course textbook and have any required assignments completed before the beginning of the course. Since this in an intensive course, assignments may be required before and after the actual course dates.

Textbook: Cultural Intelligence: Improving Your CQ to Engage Our Multicultural World, David A. Livermore, Grand Rapids: Baker Academic, 2009

Please acknowledge*

I understand this course must be completed prior to the cultural immersion to qualify for Cross Cultural Engagement credit. If completed after the travel immersion, it will not be eligible for CCE credit.

Please acknowledge*

I understand once this request has been submitted, the course cannot be dropped. (The drop/add deadline has already passed for the semester.) I may withdraw from the course by direct request to the Registrar’s Office only up to the time the course begins, and a W grade will be listed on my transcript.

Reason for requesting late registration for the CCE150 intensive*

Upcoming cultural immersion

Destination*

Sponsoring Organization*

Trip Leader*

Four

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