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 Host
4. Home campus file #
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 # 8. Date of birth
Month Day Year
9. Mailing address
Street # City State Zip
10a. Home telephone #
10c. FAX #
10b. Message telephone #
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: (If a planned course(s) is a major requirement at the home campus, approval of the Department
Chair at the home campus is required.) Use additional sheet if necessary.
Courses at Host Campus Units Units Dept. Chairman
(Use additional sheet if necessary) Q S Equivalent Courses at Home Campus Q S Approval
No. 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 purpose Resident Nonresident Fee Payment Certification
County of residence with code of
International (Visa) student at time of enrollment: No
Maximum total units approved
REGISTRAR'S CERTIFICATION: I certify that this student's residence and academic status are correct
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 Campus Seal or Stamp
or 41030 of Title 5, that the student has complied with pertinent health-related requirements, and that this
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
B. The student registered: Date No. of Units
Title Campus Seal or Stamp
Host Campus
Last Updated: March 23, 2020
The California State University
Application for Intrasystem Concurrent or Visitor Enrollment
(See instructions on back)
lease carefully review the Procedures and submit this form as directed. When submitting to CSUDH, please email to admit@csudh.edu by
the appropriate deadline
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The California State University
Policies and Procedures for Intrasystem Concurrent or Visitor 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
1. The student has completed at least one term at the home campus as a matriculated student or 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.
4. Evidence of completion of course prerequisites may be required at the host campus (i.e., personal transcripts or grade repo
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.
Health services on host campus will be limited to treatment for emergencies.
7. 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.
8. Parking on the host campus will be available on the basis of a term fee within campus parking availability or on a daily fee
9. Information concerning host campus identification card policies will be provided at registration.
1. Student completes application and submits all five copies to the Office of Admission & Records at home campus at least four
weeks in advance of the first day of classes at both campuses.
2. Home campus registrar completes Part II and forwards copies to host campus registrar if approved, or returns to student, if
3. Host campus registrar completes Part III-A and mails a copy to student with registration instructions.
4. 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 host 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. Home
campus retains a copy and delivers copies to student.
5. Student registers at host campus presenting certified copies of the application.
Host campus non-resident tuition fees and any
user fees are paid and entry is made on the copies.
6. Host campus completes Part III-B on all copies, gives one copy to student, sends one copy to home campus and retains one
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 sent to the student and to the home campus.