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Please fill out this form completely and accurately.

1.

District

2.

Phone Number

Work
Home
3.

vClass Session Dates

Start Date
End Date
4.

Read the following statements regarding the vClass SEI 45 Hour Completion Course. Check each box as you read.

I declare that I have completed the SEI Provisional training (15 or 45 hours) and will submit a copy of my training certificate to the ELAD office as documentation. I understand that if my evidence of completion for the SEI Provisional training is unacceptable, I will be dropped from this course, as it is a pre-requisite for enrollment.
All units must be completed by the end date of my designated 8 week session in order to receive credit for the course. No partial credit will be given for submitted work if I do not complete the course.
Units must be completed and required assignments submitted to the instructor weekly (one unit per week).
If I do not adhere to the schedule for course completion, unit completion, and assignment submission, I will be dropped from the course.
If I am dropped from the course, I must re-enroll and begin the course again. No previously completed work will be credited toward my next class.

By submitting this form, I acknowledge that I have read and understand the content of the statements above and agree to follow the requirements of this course as presented above.

 

 

 

 

 

You will not receive your account information unless this form is filled out completely and accurately.

5.

MPS Badge Number

6.

Contact Information

First Name
Middle Initial
Last Name
MPS Email Address
Location or Department