Online Registration Form BMP Online Course Registration Student InformationName* First Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Please enter in the following format (# # #) # # # - # # # #Email* Enter Email Confirm Email Course SelectionPlease enter the information of the course(s) for which you would like to register. You may enter a maximum of three courses.Semester* Fall 2021 Spring 2022 Course Information*Course NumberCourse Title Policy Acknowledgement* I have read and agree to abide by the following policies:1. Submitting this form constitutes my formal enrollment in the listed course(s). 2. I must notify the Certificate Program Office of any withdrawals/course changes. 3. No refunds will be given after the second class session.