MARIST Registration Form http://idcp.marist.edu AVID Certification Mr. or Ms.

Name:

Address:

City: State: Zip:

Country:

Day Phone Eve Phone:

E-mail:

Are you a citizen or permanent resident of the US? If no, indicate country of citizenship & birth: The above listed participant enters into an agreement with Marist College under which the school will instruct the participant in the training workshop listed below.

Enrollment Deadline: Registration and Payment must be received one week prior to the start of the course or examination. ACKNOWLEDGMENTS I agree to the conditions of this agreement. I also verify that I have read and received a copy of this agreement. This agreement shall be effective when signed by both the participant and the school’s representative. Participant: Date / /

Contact Info:

The Institute for Data Center Professionals (IDCP) Marist College, Hancock Center 3399 North Road Poughkeepsie, New York 12601 Telephone 845 575-3588 Fax 845 575-3095

Attention: Susan Scanlon

Email questions to: idcphelp@marist.edu

Revised Jul-15

FEES:

MC101: Editing Essentials with Avid Media

Composer $795.00

*Discount for Marist Students/Alums $695.00

Payment may be made by check or money order made payable to Marist College. To Pay by credit/debit/ACH, please contact the IDCP. Tuition includes books and AVID Certification Examination Fee Lunch provided to participants each day.

Program Selection: MC101 – Editing Essentials with AVID Media Composer 6

07/21/15 – 07/23/15 (3 Days)

MARIST Registration Form http://idcp.marist.edu AVID Certification Name:

Additional Information is requested to complete your registration and application. Items with an * are required, the others are optional. All information provided will be considered confidential and will be used for the purpose of institutional reporting only. Date of Birth (mm/dd/yyyy) *Highest Educational Level Achieved

o Some undergraduate work and number of completed credits

o Undergraduate degree

o Some graduate work

o Graduate degree

o Some post grad work

o PhD

o Other (describe)

*Degree Majors (list all, associated degree, school where degree was obtained):

*Film Editing Software Experience:

List applications:

Level of proficiency:

Current Employer: Current Job Title: Summary of Job Responsibilities: Ethnicity:

White, Non-Hispanic Asian or Pacific Islander Other

Black, Non-Hispanic American Indian or Alaskan Native

Hispanic Non-Resident Alien

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