Coursewhere Early Childhood New User ID and Password Request Form

Early Childhood Coursewhere New User ID Request Form

This form should ONLY be used by individuals that do not have a Coursewhere User ID and Password. All fields are required, except where noted as optional.

Advisory: Be very careful when entering your email address. Your ID and Password will be emailed to that address after they are created. All registration confirmations and session change/cancellation notices are sent to registrants via email only.

Early Childhood New User ID Request Form ONLY
If you are a school employee click here

First and Last Name: (middle name/initital optional)

Email address:

Learning or Childcare Center/Agency Name/School:
If you are a home day care please enter "Home Day Care"

Work Phone # and Ext: (include area code)

Home Phone #: (optional)

Address 1: (you may use your work address)

Address 2: (optional)

City:

State:

Zip Code:

County:

If you chose “Other,” please enter your county here:

Position:

If you chose “Other,” please enter your position here:

Level:

Special Needs/Comments: (optional)

Submit Clear the Form

The start of each school year is an extremely busy time. Requests for new Ids and Passwords will be completed as quickly as possible; however, it may take up to 2 business days to complete a request.

Normal business hours are Monday through Friday from 8:00 AM until 4:00 PM.

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Early Childhood Coursewhere New User ID Request Form

Early Childhood New User ID Request Form ONLY If you are a school employee click here

Early Childhood New User ID Request Form ONLY
If you are a school employee click here