St.

Petersburg Seminary and Yeshiva

An Association of St. Petersburg Theological Seminary and Netzer David International Yeshiva
Educating Servant Leaders For Ministry
3190 Gulf to Bay Blvd., Clearwater, FL 33759
727-399-0276

Course Registration Form

YEAR: ____________ TERM: Fall _____ Winter _____ Spring _____ Summer _____

Date of Registration: _________________________________ Student ID Number:__________________

(assigned by Registrar’s Office)

Last Name First Name Middle Name/Initial

Street Address City State Zip Code

Home Phone Business Phone Cell Phone Emergency Phone email address (required)
Program: G BA G MDiv G MS G MABS G MACoun G MAJS G MAMin ______________ G DMin G Yeshiva BAJS
G Yeshiva MAJS G Yeshiva MRS G Certificate G UMJC License or Ordination G Audit G Senior Audit (65 +)
COURSES REGISTERED
Class Credit/ Dis- Tuition +
Prefix Number Title In structor Day Time Audit tance* Distance Fee*

*Distance Learning includes distance learning courses and Go To Meeting courses.

Total amount of tuition and distance fees due: $________
By signing this document I also reaffirm that to the best of my ability I understand and will respect the Seminary’s statement of faith and will abide
by the Seminary’s code of conduct as published in its official documents.
Student Signature: ________________________________________ Date: _______________ For Official Use Only:
Entered in Gradpro: Date, By
Advisor Signature: ________________________________________ Date: ________________ Courses: yes ___ ____ ____
(Fax or email approval is acceptable.)

METHOD OF PAYMENT: Cash_____ Check #_______ Visa/MC_____ Scholarship_____ Install. ____

Withdrawal from a class must be processed through the Registrar’s office in order to have this contract modified!
Fee Schedule Per Credit Hour (most courses are 3 credit hours)
Tuition fee, per credit hour Certificate $185/cr* x3 = $555 Distance, additional $25.00 per course
*multiply tuition per credit hour x 3 for Bachelors $205/cr* x 3 = $615 Distance, additional $25.00 per course
total tuition cost for each course Masters Distance, additional $25.00 per course
$245/cr.* x 3 = $735
Doctorate $305/cr.* x 3 = $915 Distance, additional $25.00 per course
Audit fee, No academic credit, per credit hour $120/cr.* x 3 = $360
Distance, additional $25.00 per course
Senior Audit fee, 65 and older, per credit hour $90/cr.* x 3 = $270
Revised 1-18-16