Nova Southeastern University
Oceanographic Center

Distance Education Registration Form

(to be printed out and either faxed or sent by "snail-mail")


Print out and either
Mail to:Fax to:
Distance Learning Registrations
Institute of Marine and Coastal Studies
NSU Oceanographic Center
8000 North Ocean Drive
Dania Beach, FL 33004
(954)262-4020
Or save to disk and email as an attachment to: imcs@mail.ocean.nova.edu
with a cc: to douganj@nova.edu

Please check the course(s) you are registering for:
_____ Biology of Sharks and Rays
_____ Biostatistics
_____ Chemical Biology of Coastal Zones
_____ Coastal Policy
_____ Coastal Pollution and Environmental Toxicology
_____ Coastal Zone Interpretation
_____ Coastline Environmental Security
_____ Environmental Remote Sensing and Geographic Information Systems
_____ Environmental Sustainability: Choices for the Future
_____ International Integrated Coastal Zone Management
_____ Internship in Coastal Policy
_____ Life on a Water Planet
_____ Marine Chemistry
_____ Marine Ecosystems
_____ Marine Geology
_____ Marine Mammal Management
_____ Physical Oceanography (Introduction)
_____ Resolving Environmental and Public Disputes
_____ Water: Cross-cultural, scientific and spiritual perspectives

In signing below, I acknowledge that I am aware of the OC policy with regard to course withdrawals and refunds.

Name: ___________________________________________________

Address: _________________________________________________

City: ______________________ State: ________________________

Postal/ ZIP Code: ________________ County: __________________

Phone number: _____________________

e-mail: ___________________________________________________

How did you learn about our distance learning courses? ________________________

________________________________________________

Level of study required:

General Interest _____ Undergraduate ______ Graduate ______

Do you wish to apply for the Graduate Certificate in Coastal Studies ________________

If this is the first time that you are applying for the full graduate credit option or the Graduate Certificate,
a copy of your undergraduate degree is required. You can either fax a copy of your degree to (954)262-4020,
or scan an electronic image and email to disted_1@mail.ocean.nova.edu.

After the receipt of this form, you will be contacted for additional information.

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