Science Registration Form SU11

New England School of Acupuncture SCIENCE COURSE REGISTRATION FORM Summer 2011 Term Calendar: Monday, May 9th – Monday, August 8th 2011 No classes Monday, July 4th – Saturday, July 10th Name: _____ Soc. Security #: Address: City, State, ZIP: Primary phone(s): E-mail Address: Summer 2011 Science Schedule Please check the course(s) for which you are registering: Anatomy & Physiology I (5/9 -6/21) M/W Anatomy & Physiology II (6/23-8/2) M/W Anatomy Lab Sat Biology T Biochemistry T General Chemistry M Microbiology W 5:00 pm - 8:45 pm 5:00 pm – 8:45 pm 9:00 am – 2:00 pm 12:45 pm – 4:30 pm 9:00 am – 12:45 pm 12:45 pm – 4:30 pm 12:45 pm – 4:30 pm □ □ □ □ □ □ □ Note: Anatomy & Physiology I is a pre-requisite to Anatomy & Physiology II. General Chemistry is a prerequisite to Biochemistry. Each science course costs $525.00. Payment is required in full at the time of registration. Number of Courses: _____ x $525 = $________ Seats are allotted on a first-come, first-serve basis. You will receive a confirmation via e-mail upon receipt of your payment; there are no refunds after the first class meeting. Return this form with your payment to: Registrar, New England School of Acupuncture, 150 California Street, Newton, MA 02458. Checks should be made out to “NESA” Attention: Non- Matriculating Students If you are currently taking western science courses with the intention of enrolling at NESA, but you have not yet applied to the program, please contact the Admissions Department as soon as possible at (617) 558-1788 x105. We strongly encourage you to apply to the program BEFORE attempting to complete all the Introductory and Co-Requisite science courses. Signature: Date: