MEM Course Registration Contact Information* Indicates Required Fields Name First Name MI Last Name Current Mailing Address Street Apartment City State --Select-- AA AE AP Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Code Email Preferred Email ODU Email Additional Email (optional) Phone Preferred Phone Number Additional Phone Number (optional) University Identification Number UIN? (if known) Personal Last Four of your SSN Gender Male Female When were you born? --Select-- January February March April May June July August September October November December --Day-- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 --Year-- 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 Military What is your rank? Citizenship Are you a US citizen? Yes No Type of Visa? Employment Employer or Command/Unit Where are they located Educational Background Do you hold a bachelor's degree? Yes No If Yes... What is your degree? What University/College? Are you a graduate of ONPS/Prototype or BRES/KAPL Reactors Engineering Program? Yes No If No... Preapproval is required for non-graduates of ONPS/Prototype or BRES/KAPL program. Have you been preapproved? Yes No I have completed the online Responsible Conduct of Research (RCR) training. (Click here for instructions on RCR training.) Yes No Course Registration Have you applied for admission to the Masters of Engineering Management Program? Yes No What course would you like to register for? --Select-- ENMA 600 - Cost Estimating and Financing Analysis ENMA 601 - Analysis of Organizational Systems ENMA 603 - Operations Research ENMA 604 - Project Management ENMA 605 - Capstone ENMA 613 - Logistics & Supply Chain Management ENMA 614 - Quality Systems Design ENMA 715 - Systems Analysis ENMA 724 - Risk Analysis ENMA 743 - Reliability & Maintainability ENMA 771 - Risk & Vulnerability Semester dates? --Select-- 20 May 13 - 18 Aug 13 (Summer Term) 27 May 13 - 25 Aug 13 (Summer Term) 3 Jun 13 - 1 Sep 13 (Summer Term) 10 Jun 13 - 8 Sep 13 (Summer Term) 17 Jun 13 - 15 Sep 13 (Summer Term) 24 Jun 13 - 22 Sep 13 (Summer Term) 1 Jul 13 - 29 Sep 13 (Summer Term) 8 Jul 13 - 6 Oct 13 (Summer Term) 15 Jul 13 - 13 Oct 13 (Summer Term) 22 Jul 13 -20 Oct 13 (Summer Term) 29 Jul 13 -27 Oct 13 (Summer Term) 5 Aug 13 -3 Nov 13 (Summer Term) 12 Aug 13 -10 Nov 13 (Summer Term) Payment Planned method of payment --Select-- SelfPay Tuition Assistance (TA) Graduate Education Voucher (GEV) GI Bill - Ch 33 Post 9/11 GI Bill - Ch 30 MGIB Other If "Other" please specify? The current MEM CD-ROM tuition rate is $397 per credit hour. Please ensure that all payment documentation (TA forms, GEV vouchers, etc.) reflects this rate. Send all payments, approved TA/GEV forms, and other tuition funding documents directly to the ODU Office of Finance. Monitor your tuition due amount through your ODU MIDAS account. Click here to create an account. Tuition is fully obligated upon receipt of registration. No refunds if the student withdraws more than ten (10) days after the course start date. Student loans/deferments must be approved before registering for courses. If using student loans, ensure that your selected course term dates fall within ODU regular semester dates. Submitting Your Registration By clicking "Submit" you certify that all information provided is correct, you have complied with the registration instructions, and understand and agree with all information as listed above. I understand that tuition is due within 10 business days upon submission of this registration form. Old Dominion University Honor Pledge: I pledge to support the Honor system of Old Dominion University. I will refrain from any form of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a member of the academic community it is my responsibility to turn in all suspected violators of the honor code. Authorization: If applicable or required by law (i.e. active-duty military members using Tuition Assistance or other government educational funding) I authorize release of my academic records to the United States government under provision of the Family Education Rights Act of 1974 during the period while I am participating in the MEM program. I certify that all information provided is correct and I am in compliance with the registration instructions.