Registration Form part #1 - STT.pmd
OFFICE USE: PIP –Prerequisite in progress, PNM- Prerequisite not met, CTC-course time conflict, CLS- Closed class, CRN- Wrong CRN, WTL- Waitlisted Advisor’s Signature Student signature 1. The registration form must be COMPLETED PRIOR to entering the registration area, as it will be used to key your course request(s). 2. Please make sure the COURSE REFERENCE NUMBER (CRN #) has been entered correctly. Schedules must have a CRN# to be entered. 3. Changes in biographical data (name, address, phone #) must be reported to the Office of Enrollment Management. Fall Spring Summer Yr. _________ Date:_______________ Course Level: Undergraduate Graduate Daytime Phone #:_____________ SS#:___________________ Name:_______________________________________ Last First M.I. …
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OFFICE USE: PIP –Prerequisite in progress, PNM- Prerequisite not met, CTC-course time conflict, CLS- Closed class, CRN- Wrong CRN, WTL- Waitlisted Advisor’s Signature Student signature 1. The registration form must be COMPLETED PRIOR to entering the registration area, as it will be used to key your course request(s). 2. Please make sure the COURSE REFERENCE NUMBER (CRN #) has been entered correctly. Schedules must have a CRN# to be entered. 3. Changes in biographical data (name, address, phone #) must be reported to the Office of Enrollment Management. Fall Spring Summer Yr. _________ Date:_______________ Course Level: Undergraduate Graduate Daytime Phone #:_____________ SS#:___________________ Name:_______________________________________ Last First M.I. Address_____________________________________ Mailing City St Zip SAMPLE SCHEDULE CRN# SUBJ CRSE# SEC CRED DAY TIME AUDIT CRN# SUBJ CRSE# SEC CRED DAY TIME AUDIT Alternate Course Selection (s) Total Credits: [ ] 12345 MAT 231 A 4 MTWF 1:00-1:50 Office Use Email: GENERAL INSTRUCTIONS/INFORMATION REGISTRATION FORM University of the Virgin Islands Registration Form Social Security # Fall Spring Summer 20 Campus: STT STX Level: Undergraduate Graduate Name: Last First Middle Former Permanent Address: Local Mailing Address: Zip Zip Phone: Home ( ) Work:( ) Ext Sex: Male Female U.S. Citizen Yes No Permanent Resident Date of Birth: Alien Registration # DD MM YY Non Resident Alien: Type of VISA F J H In compliance with federal reporting requirements, UVI must seek to identify the ethnic background of students enrolled. You are encouraged to supply this information. 1. Black/Non-Hispanic 3. Asian/Pacific Islander 5. White/Non-Hispanic 2. American Indian/Alaskan 4. Hispanic 6. Other In what state/country is your permanent residence? Have you lived in the Virgin Islands for the past twelve (12) months? Yes No Last attended UVI I certify that the information given on this form is complete and correct. I acknowledge that deliberate omissions or falsifications may subject me to immediate dismissal from the University. Under the provisions of the Family Educational Rights and Privacy Act of 1974, as Amended, you have the right to withhold the disclosure of any directory information. If you would like that your name not be listed in a directory please indicate. Yes No Student’s Signature Date