Registration Instructions for Cardinal Stritch University

You may register by phone or by completing and printing this registration form and sending it to Cardinal Stritch University. There is no online registration option available at this time.

Registration and Payment Information
Phone: Call 800-347-8822 Ext. 4428 with a VISA or MasterCard 9AM to 5PM Central Time.
Mail: Complete and print this registration form and mail with payment to Cardinal Stritch University, Outreach Dept. #509, 6801 N. Yates Rd., Milwaukee, WI 53217.
FAX: Print this registration form, complete it with VISA, MasterCard, or Discover information and FAX to 414-410-4347.

Group Registration Instructions
To qualify for group discounts, all group members must register online on the same day. You must select a group leader. In the Discount Code box on the online registration form, put the group leader’s name followed by the number of group members (e.g. “Thompson-2”).

Personal Information
First Name
Middle Initial
Last Name
Social Security # (last 4 numbers)	(e.g.: XXX-XX-6789)
Date of Birth	(Required)
Home Address
City
State/Province
Country
Postal Code
Where You Teach

School Name
School Address
City
State/Province
Country
Postal Code
School Phone	(e.g.: 888-555-1212)
Home Phone
Home Email
Gender	Female Male

Course Cost

Regular Course Fee: $330 per course. Please see the home page for additional discount information.
How do you hear about QEP courses?

Friend/Colleague Print brochure Email promotion Search Engine (Yahoo, Google, etc.) You Tube University brochure or catalog Other or can't remember
I am a . . .

Returning customer New customer
Shipping and Handling

All orders will be shipped Priority mail. A shipping and handling fee of $6.00 will be added to all orders. This fee is waived on group orders of three or more students in the U.S.

Payment Information (MasterCard, VISA, Discover Cards)

Enter Course Cost
Shipping and Handling $6.00
Total Cost
Discount Code
Name on Card
Card Number	(no spaces)
Expiration Date	(mm/yy)
Card Verification Code	(CVC)

Review and Submit

Please review your information to ensure the order is processed correctly. Then print this form and fax it or mail it along with payment to Cardinal Stritch University (see above). Thank you for your interest in our courses.
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