This not an interactive enrollment form. You may copy it, fill in the data, and e-mail it to info@sfia.net, or copy, print, and fax it to 510-523-5175, or mail it to the address below, or call your information in to 800-634-7779 or 510-523-5174 in the San Francisco Bay Area.

Date of enrollment:

Please enroll me in the Master of Ecological Design Degree Program ($300 U.S. per course). I understand you will e-mail the course textbook list and study instructions within seven days of processing of my enrollment.

Name:

Job position and firm or institution name (if applicable):

Address:

City:

State:

Zip:

Phone:

Cell Phone:

Fax number:

E-mail address:

I am a degree candidate for:

___ Master of Ecological Design Degree (75 units)

Tuition:

___ Please enroll me in the Master of Ecological Design Degree Program

___ Please enroll me in the course I’ve listed below ($300 U.S. per course)

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

____ I understand I’m responsible for purchasing my textbooks per the textbook list that will be provided with study instructions.

____ I am paying by check or money order (payable to SFIA).

____ I am paying by Credit Card.

Card number:

Expiration date:

Cardholder’s full name:

Note: Credit card statement will show “SFIA/Guidelines.”

Refund policy:

After enrollment and receipt of study materials, you will have fourteen days in which to decide to withdraw with no penalty. After fourteen days, a $200 withdrawal fee will be charged, along with $100 for each subsequent month you’ve been enrolled in the program.

SFIA Information Office
Box 2590
Alameda, CA 94501
USA

phone 510-523-5174
toll free1-800-634-7779
fax 510-523-5175
info@sfia.net
www.sfia.net