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Online Enrollment Form

Distance Education Certificate Program Enrollment Information
Plan A: Course Modules and Standard Electives, $2950 (The orientation module will be sent to you)

Payment Selection
I will pay in full ($2950)
I will pay in installments ($660 initial installment, $458 each month for 5 months)

Payment Method
Credit card - You will be forwarded to the University of Wisconsin-Madison's secured server to complete this transaction.

Check or purchase order (payable in U.S. funds to UW-Madison). Mail to:

Distance Education Professional Development
University of Wisconsin-Madison
21 N. Park St 7th Floor
Madison, WI 53715-1218

Invoice (type billing instructions and address in the box below. Please include your purchase order number.)

Other (type billing information in the box below)

If you prefer to pay by credit card over the phone rather than online please call our office at: (608)263-1154.

Contact information

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