The California State University
Application for Intrasystem Concurrent Enrollment
(See instructions on next page)
This application is to be used by California State University students who wish to enroll concurrently at another CSU campus.
(A) 1. Home campus 2. Proposed host campus
3. Semester/Quarter of enrollment: Home Campus Host Campus
4. Home campus student ID #
5. Have you previously attended the proposed host campus? Yes No
If yes, what was the last term of attendance? (term/year)
6. Legal name
Last First Middle Maiden
7. Social Security Number* 8. Date of birth
Month Day Year
9. Mailing address
Street # City State Zip
10a. Home telephone # ( ) 10b. Message telephone # ( )
10c. FAX # ( ) 10d. E-Mail
11. Class level at time of planned enrollment:
Freshman Sophomore Junior Senior Graduate Postbaccalaureate
12. Major field________________________________________ and/or credential objective________________________
13. Are you receiving financial aid? Yes No
(B) Listing of course(s) planned at host campus: Care should be taken to assure that coursework completed at host campus can be used to meet home
campus requirements.
Units Home Campus
Courses at Host CSU Campus Q S Courses at Home CSU Campus Q S Approval
Number of units planned at home campus ___________
I certify that the information I have entered above is true and that I have read and understand the eligibility requirements, enrollment conditions and
procedures as stated.
Student's Signature Date
Residence status for fee purposes: Resident Nonresident
Fee and/or Nonresident Payment
County of residence Certification
International (Visa) student at time of enrollment: No Yes
Maximum total units approved Fees Paid for ___________term
of___________ = $__________
REGISTRAR'S CERTIFICATION: I certify that this student's residence and Academic status are correct (year)
according to the official records of this campus, that the student is eligible as of this date to register as a
continuing student, that the student qualifies for temporary transfer in accordance with Section 40808 or __________________________
41030 of Title 5, that the student has complied with pertinent health-related requirements, and that this
Signature of Home Campus Official
institution approves this request for temporary enrollment for one term only.
Signature Date
Title Home Campus
A. Approval for enrollment at host campus: Granted Denied Date
Fee Payment/Nonresident
Tuition Certification
Signature Title Fees Paid for
of ________(if any) = $_______
B. The student registered: Date Number of Units
Signature Title
CSU Host Campus
* Not used as an ID number and will not be communicated to third party.
Select Campus
Select Campus
Fall 2013
Fall 2013
Equivalent Requirements or
The California State University
Policies and Procedures for Intrasystem Concurrent Enrollment
Eligibility Requirements
1. Student has completed at least one term at the home campus as a matriculated student and earned at least 12 units there.
2. Student has attained a grade point average of 2.0 in all work completed at the home campus and is in good standing at that
Student will be/is enrolled at home campus during the period of concurrent enrollment at host campus and has paid
tuition fees as a full-time student.
1. The student has completed at least one term at the home campus as a matriculated student and will be enrolled
concurrently in such status.
2. The student has been admitted to or is enrolled in an authorized graduate program at the home campus.
3. The student was in good standing at the last college attended.
Enrollment Conditions
1. Approval of concurrent enrollment is valid only for the term specified and is subject to space availability and registration
priority policies at host campus.
2. Academic advisement is available only at the home campus.
3. Concurrent enrollment is possible only in overlapping terms, e.g. semester campus to sem. campus, quarter to
4. Evidence of completion of course prerequisites may be required at the host campus (i.e., personal transcripts or grade
5. Financial aid is available only through the home campus and students eligible for veterans, rehabilitation, social security
and other federal, state or county benefits must secure eligibility certification through the home campus.
6. Participation in student activities at the host campus is subject to any limitations, which may exist at that campus.
Similarly, student union facilities will be available according to policies at each campus.
7. Parking on the host campus will be available on the basis of a term fee within campus parking availability or on a daily
fee basis.
8. Information concerning host campus identification card policies will be available at the time of registration.
1. Student completes application and submits to the Office of Admission & Records at home campus well in advance of
the first day of classes at both campuses. Contact host campus for deadlines, if any.
2. Home campus Registrar designee completes Part II and forwards to host campus registrar designee if approved, or
returns to student, if disapproved. The approved application may be given to student so that he/she can submit it to
host campus.
3. Host campus registrar completes Part III-A and provides a copy to student with registration instructions.
4. Concurrently enrolled student pays CSU registration fees on home campus based upon the total number of units for
which she/he is or plans to be registered including units on the home as well as host campus(es), e.g. three units at
home and three units at host equals part time fees, and six units at home and 3 units at host equals full time fees.
Payment is certified on all copies of the application. Home campus non-resident tuition fees, as appropriate, are paid at
the same time and entry made with the fee certification.
5. Student registers at host campus presenting approved copy(ies) of the application. Host campus non-resident tuition
fees and any user fees are paid and entry is made on the application for concurrent and/or visitor status.
6. Host campus completes Part III-B.
7. Program changes will be accomplished by following standard procedures on both campuses. Official notification will
be provided by the host campus to the home campus. If a student withdraws from the home campus and requests
refund for the refundable portion of the State University fee, the host campus must be notified.
8. Permanent academic records will be maintained at the campus where courses are completed. A record of credit earned
at a host campus will be available to the student and to the home campus upon request by the student or registrar of the
home campus.
ICE Form/2013