Post-baccalaureate classes for
license renewal or upgrade
and additional endorsements

Professional Development

Learners Edge Application

Term for which you are registering

Learner’s Edge Course(s) for which you are registering: LEN#
Separate each course number with a comma.*

Name*

Previous Name

SSN#

Address

City

State

Zip

Preferred phone

Email*

Date of birth*

Gender
Male
Female

Are you a legal resident of Ohio with 12 months continuous residence?
Yes
No

US Citizen
Yes
No

If no, list country of citizenship

Visa type

Place of Employment

Employer phone

Have you ever taken classes through Lourdes University?*
Yes
No

College/university where undergraduate degree was earned

Dates Attended (Month/Year)

Degree Received

Do you have a valid Ohio Teacher Certificate/License?
Yes
No

If yes, Licensure Area

Are you a veteran?
Non-Veteran
Pre-Vietnam Era
Vietnam Era
Post-Vietnam Era

By checking this box, you affirm:
1. All information that you have provided is correct and complete.
2. Any misrepresentation of facts on this application could be cause for denial of admission or dismissal from the University.
3. If you are accepted by Lourdes University, you will be expected to abide by all University regulations and rules.
4. Lourdes University representatives have your permission to release your name and financial aid information for scholarship nomination and recognition.
5. You authorize any colleges and universities you have previously attended to release personal and academic information to Lourdes University.

Submit

* Required

Contact

Carolyn Jaksetic
Director of School and Educational Partnerships
Department of Education
419-824-3661

Learn More

Professional Development
Professional Development Application, Learner's Edge
WGTE Professional Development
Graduate Endorsements
Community Resource Workshop

Education

Undergraduate Programs

Graduate Programs

Graduate Students

Next Steps

Learners Edge
Application

Learners Edge Application

Contact

Learn More

Education

Undergraduate Programs

Graduate Programs

Graduate Students

Next Steps

Learners EdgeApplication

Learners Edge Application

Contact

Learn More

Learners Edge
Application