Adult Continuing Education (ACE) Non-Credit Registration Form
STUDENT INFORMATION (PLEASE COMPLETE ALL FIELDS AND PRINT CLEARLY)
Date of Birth (MM/DD/YYYY)
Primary Phone: Secondary Phone:
Primary Email Address (conﬁrmation will be sent here)
Last Name First Name Preferred Name MI ID # (if returning)
Fall Winter Spring Summer
Signature required of student or parent/legal guardian if student is under 18 years of age.
Class number Class dates Day(s) Meeting timesTitle
Yes NoDo you consider yourself to be Latino/Hispanic?
In addition, select one or more of the following racial categories to describe yourself:
How did you hear about us?
Native American Asian WhiteBlack or African American
A New SAIC studentI am : A Returning SAIC student A Certiﬁcate Program student
Brochure Email Friend I am a returning student SAIC Website Teacher
The Art Institute of Chicago
EMERGENCY CONTACT INFORMATION
Relationship to student
Last Name First Name
Phone: Mobile Home Work
Mobile Home Work Mobile Home Work
CONTINUING STUDIES ACKNOWLEDGMENT + AGREEMENT
understand that I am ﬁnancially responsible for the course(s) for which I am registering.
A 100 percent tuition refund will be issued one week prior to the session start date. All requests to drop a course must be submitted in writing
to firstname.lastname@example.org and include the student’s name, ID number, and course information.
I give SAIC permission to obtain emergency medical care, hospital, or clinic treatment for me.
I hereby waive liability against SAIC for such care and for transportation provided to such locations as deemed necessary by SAIC.
I have read and agree to abide by the Rights and Responsibilities for ACE Students, available online at saic.edu/ace > Forms and Downloads
I have read and agree to the terms outlined on the ACE Media Consent Form, available online at saic.edu/ace > Forms and Downloads
I agree with the foregoing on behalf of myself/my child or ward.
All students will receive an ARTICard, SAIC’s mandatory identiﬁcation card. Please visit saic.edu/articard for more information.
ARTICARD (Student ID)
click to sign
click to edit