Seton Hall University
College of Education and Human Services
Graduate Studies and Special Programs

Certificate in Information Technologies

Mail-in Application Form

I would like to enroll in the Information Technologies Certificate Program

Name______________________________________________________________________________

Address____________________________________________________________________________                                             Street                                             City                                                      State                                      Zip  

Home Phone__________________________Business Phone________________________________

SS#____________________________E-mail Address_______________________________________

Are you a matriculated student at SHU?__________Undergraduate or Graduate________________

School/College__________________________________Department___________________________

Please detach and send to:   Dr. Rosemary W. Skeele     College of Education and Human Services

Room 442     Kozlowski Hall     Seton Hall University     South Orange, NJ 07079

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