Scribd
Upload
257 views

Student Registration Form - Sample: (Institute Name)

This student registration form collects student information such as name, address, phone number, email, social security number, and emergency contact. It also requests course information including course name, number of credits, section, and instructor signature if registering without prerequisites. By signing, the student agrees to abide by institute policies and procedures and pay tuition, fees, and collection costs if applicable. The form is used by an institute to register students for courses.

Uploaded by

shweta verma
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
257 views

Student Registration Form - Sample: (Institute Name)

This student registration form collects student information such as name, address, phone number, email, social security number, and emergency contact. It also requests course information including course name, number of credits, section, and instructor signature if registering without prerequisites. By signing, the student agrees to abide by institute policies and procedures and pay tuition, fees, and collection costs if applicable. The form is used by an institute to register students for courses.

Uploaded by

shweta verma
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 1

STUDENT REGISTRATION FORM -sample

[INSTITUTE NAME]

STUDENT INFORMATION: Complete the information below. Please print clearly.


Name_________________________________________________________________ Student ID Number_________________________________________________

Former Name (if applicable) _____________________________________________ Social Security Number _____________________________________________

Permanent Address _______________________________________ Apt #_______ Phone (home) _____________________________________________________

City/State/Zip__________________________________________________________ Phone (cell) _______________________________________________________

County of Residence___________________________________________________ Email_____________________________________________________________

Local Address (if different than above) ______________________________________________________ Emergency Contact Name_____________________________________________

City/State/Zip__________________________________________________________ Emergency Contact Phone_____________________________________________


Birth Date (Month/Day/Year): _____/_____ /_____
Gender: r Male r Female Graduated from High School? r Yes r
No

Course Name/Number Credits Section Sub Type Audit Instructor Signature


Instructor approves that the student may register for the course without the
sample: ENGL 101 3 MO1 LEC N
prerequisite.

Student Agreement:
I agree to abide by all College/campus policies and procedures.
I agree to pay [INSERT INSTITUTE] for tuition and fees and any reasonable collection costs if applicable.

Student Signature: ___________________________________________________________________________________________ Date: _______________ Advisor

Signature: ____________________________________________________________________________________________Date: ______________

You might also like