Youth Development Certificate

Online Application

Thank you for your interest in the Youth Development Certificate Program. Please take a moment to fill out this application form.

1. Please return a completed, signed copy to:

Center for Urban Youth Development
The School for Social Change
Campolo College, Eastern University | Philadelphia
990 Spring Garden Street, Sixth Floor
Philadelphia, PA 19123

2. Enclose application fees in the amount of $35.00 by check payable to Eastern University.

3. Do not include payment of other fees. Accepted students will be billed for tuition payment and applicable per-credit costs at a later date.

  • If pursuing a certificate only, submit only this form.
  • For graduate credit, also submit an official college transcript as proof of your undergraduate degree (2.5 GPA required). 
  • For undergraduate credit, also submit proof of your high school diploma or equivalency. 

Contact Information

First Name

Last Name

Email Address

Home Phone

Work Phone

Address Line1

Address Line2

City

State

Zip/Postal Code

Employer/Affiliation Information

Full Time

Part Time

Volunteer

Organization Name

Job Title

Address Line1

Address Line2

City

State

Zip/Postal Code

School Information

High School/University Attended

Year of Graduation

Other Colleges/Universities attended

Program Options

Individual Courses or Certificate Only ($140/cr)

Continuing Education Credits (CEU) Only ($140/cr)

Undergraduate Credit ($435/cr)

Graduate Credit ($530/cr)

Please check here if you intend to obtain this credit in pursuit of a degree at Eastern University

Other Information

How did you hear about the School?

Questions/Comments:

 


 

 

School for Social Change
Campolo College of Graduate and Professional Studies
Eastern University | Philadelphia
990 Spring Garden Street, Sixth Floor
Philadelphia, PA 19123

P: 215-769-3100
F: 215-769-6785
E: change@eastern.edu
AIM: studychange

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