Fall 2009 Paralegal Certificate Program Enrollment Form

Payment or the Request for Incremental Payment Plan Form must accompany this form. Print out and mail or fax to the Friday Center.

Name_____________________________________________________________________________

Mailing Address_____________________________________________________________________

City_________________________________________________State_______Zip________________

Daytime Phone (______)_____________________________________________________________

E-mail (please print clearly) ___________________________________________________________

UNC-Chapel Hill uses the Personal ID number (PID) to aid in keeping records for students and participants. If you already have a PID, please enter it. PID #__________________________________________________

If you do not already have a UNC PID, one will be assigned to you. Please provide the following information required for PID number creation:

Gender: M   F     Birth Date____________________________________________________

Highest degree earned ______________________________________________________________

Please indicate the accommodations and/or services you require to participate: ________________________________________________________________________________

Payment or the Request for Incremental Payment Plan Form must accompany this form. Payments by credit card may be received by mail, fax, or phone.

Check payable to the Friday Center (Federal ID#56-6001393).

VISA or MasterCard (Only VISA and MasterCard are accepted. Note that debit cards requiring the use of a PIN for all transactions are not accepted.)

Mail or fax this form with payment to:
Fall 2009 Paralegal Certificate Program (2603)
CB 1020, The Friday Center, UNC-Chapel Hill
Chapel Hill, NC 27599-1020
Fax: 919-962-5549