Office Use
Only
Student ID#
Initials
UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www.alaska.edu/titleIXcompliance/nondiscrimination.
Non-Degree‐Seeking
Application
Directions: Please print legibly or type. Be sure you have signed and dated the application. Non degree‐seeking students are taking
courses for
personal interest, professional development, or recreation. Non degree‐seeking admission status remains active as long as you register for at least
one course per academic year. Students who miss more than one academic year must re‐submit upon return. If you intend to earn a certificate,
a degree, or plan to apply for financial aid, please apply online at UAOnline.alaska.edu.
Semester
Spring
Summer
Fall Year
:
Name:
(Last) (First) (MI)
Gender:
Male
Female Previous or
Maid
en Name
:
Date of Birth:
Social Security Number:
The University of Alaska has established student identification numbers and does not use Social Security numbers for student identification. The university is still
required to collect a valid Social Security number from each student for IRS, employment and federal financial aid purposes. The last four digits of the Social
Security number are included on official transcripts for identification matching purposes.
Name of High School:
Current High School Student?
Yes
□
No
□
Date
of
High
School
Graduation
or
GED (or anticipated date)
:
Citizenship:
U.S.
□
Other:
Mailing
Address:
City:
State:
Zip
Code:
Phone: ___________________________________ Phone (Alternate):
In what state do you claim official residency?
If you claim Alaska residency, how long have you lived in Alaska? Years: Months:
Are you currently active military or a military dependent? YES NO
Are you an honorably discharged U.S. veteran or eligible dependent?
YES NO
Email:
Student
Signature:
Date:
