Request to enroll in MAT 210 ONLINE Summer or Fall 2018

THIS FORM IS ONLY FOR MAT 210.
For online courses with such as MAT 310, MAT 114 or MAT 100 use the correct form on https://www.usm.edu/gulfcoast/science-technology.
For MAT 099, 101, 102, 103, 115, and 167 online, please contact the instructor directly or the mathematics department (Ms. Lisa Mims at l.mims@usm.edu).
Online mathematics courses are for students in an online program, for those who work full time or those who have other special circumstances. In particular MAT 210 and MAT 310 online are designed for students in the Teacher Assistant Program After seats are filled with those students, remaining seats may be open to others.

Please know that tests may require face-to-face or online proctoring.

For more information, contact Marlene Naquin at marlene.naquin@usm.edu.

Please read each field carefully and completed as needed-including choosing the correct semester and using only your official USM school email.

Failure to complete every field correctly will result in immediate denial of permission to enroll. The student, not the advisor, should complete the form.
Please select the correct semester for which you are requesting enrollment. *

Please select the correct semester for which you are requesting enrollment. MAT 210 online SUMMER 2018 MAT 210 online FALL 2018
Full Name as registered at Southern Miss: *
EMPL/Student ID Number: *
OFFICIAL SCHOOL EMAIL ADDRESS (first.last@usm.edu). Please be certain it is correct. Do not use youir eagles or personal email address such as gmail, yahoo, att, cable one or your junior college email. If you fail to use your official SCHOOL email (first.last)@usm.edu) your request will not be reviewed. *

Without your school email address, your request may not be processed.
City and State of Residence while enrolled in course. *
The prerequisites must be indicated on your transcript in order for you to enroll in the course requested: at least a C or better in MAT 101 (College Algebra).
After reading the prerequisites: *

After reading the prerequisites: I have successfully completed College Algebra and it is recorded on my transcript.

Be certain you have the prerequisites before requesting to be enrolled.
Why are you requesting to take this course online instead of a face to face lecture? Your response will be verified before enrollment. *

Why are you requesting to take this course online instead of a face to face lecture? Your response will be verified before enrollment. I am a TAP student. You must already have a position at a school as a TA. I have a schedule conflict with the face to face offerings If there is another reason not stated above, please indicate in the box below
Home campus *

Home campus Online (teacher assistant program) Gulf Park Hattiesburg

If you are in the Teacher Assistant Program, please be certain the Mrs. Patti Papania has your documentation.
Your major at Southern Miss *
Your advisor *

Please include name and email address
Advisor's phone number Advisor's phone number * - ### - ### ####
Advisor's email *
Do you work? *
If you work, where do you work? *
Contact name and number for your work supervisor: *
If you work, number of hours you work per week: *
Please know that some tests may require face-to-face or online proctoring.
Once your form is received your request for enrollment will be determined. If you will not be enrolled you will receive an explanation by email. If you are given permission by the instructor to enroll you will be quick enrolled. The prerequisites must be indicated on your transcript in order for you to enroll in the course requested.
If you are enrolled without instructor permission you will be dropped until you receive permission. Please allow at least 48 hours for your request to be processed during normal school office hours.
For more information:
Ms. Marlene Naquin at Marlene.Naquin@usm.edu
I am aware that online classes require a certain amount of independence in scheduling time to devote to the coursework. During the semester I will make it my responsibility to keep abreast of the required work and due dates through following announcements, emails, checking Canvas and the homework website. I will participate as needed in live chats using Canvas. I am also aware that some tests may be proctored in person or online. Please sign using your mouse or touch pad. (I know it may not look like your actual signature) *

Clear
You must sign.

Request to enroll in MAT 210 ONLINE Summer or Fall 2018

Request to enroll in MAT 210 ONLINE Summer or Fall 2018

Please read each field carefully and completed as needed-including choosing the correct semester and using only your official USM school email.

The prerequisites must be indicated on your transcript in order for you to enroll in the course requested: at least a C or better in MAT 101 (College Algebra).