Fillable COURSE REGISTRATION FORM (University of Wisconsin - Stevens Point)

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COURSE REGISTRATION FORM (University of Wisconsin - Stevens Point)

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COURSE REGISTRATION FORM
A $100 Registration Deposit must accompany your registration form (see page 2 for payment options).
Last Name
First Name
Middle
Maiden Name
Home Address
City
State
County
UWSP ID Number or Social Security Number
Date of Birth (month/day/year)
Home or Cell Phone
Email Address (required)
High School City/State Year of H.S. Graduation
Have you previously taken courses offered by UW-Stevens Point? Yes No
Race/Ethnicity: Please answer both a and b.
a. Ethnicity: Are you of Hispanic or Latino origin? Yes No
(If yes, choose one or more from the list below.)
Mexican, Mexican American, or Chicano Puerto Rican
Other Hispanic/Latino Cuban
b. Race: Choose one or more from the list below.
African-American or Black Laotian
American Indian or Alaskan Native Vietnamese
Native Hawaiian or Other Pacific Islander Other Asian
Cambodian White
Hmong
Course(s) for which you are registering (E.G. Education 570)
Section
Credits
Term
Year
Permission Required Courses – If a “PR" appears in front of courses in the Timetable, then permission from the department is required for enrollment. You must
obtain electronic
authorization by the chair of the department for all such courses and sections prior to your registration being processed. Please email the appropriate department with your
request
http://www.uwsp.edu/admissions/Pages/Academics/default.aspx.
RESIDENCY: Under the law, it is your responsibility to register correctly as a resident or nonresident.
Office Use Only
N R
1. Have you, your spouse or parent(s) recently moved to Wisconsin to accept permanent employment? Yes No
2. Do you claim legal Wisconsin residence for tuition purposes? Yes No
3. Indicate the dates you have lived at your present address From (month/year)________ to (month/year)________
4. List former addresses (street, city, state) within the last two years
__________________________________________________________________________________________ From (month/year)________ to month/year)________
__________________________________________________________________________________________ From (month/year)________ to (month/year)________
5. Employment history and/or activities for the last two years (include city/state)
__________________________________________________________________________________________ From (month/year)________ to (month/year)________
__________________________________________________________________________________________ From (month/year)________ to (month/year)________
6. Parent’s Name, City, and State of residence within the last two years
___________________________________________________________________________________________ From (month/year)________ to (month/year)________
___________________________________________________________________________________________ From (month/year)________ to (month/year)________
Student Signature _______________________________________________________________________ Date ______________________________
Gender: Male (M) Female (F)
Veterans Benefits Status:
Not a Veteran (0)
Receiving VA Benefits (2)
Veteran Not Receiving Benefits (9)
Citizenship:
Citizen (C)
Non-resident Alien (N)
Permanent Immigrant (P)
Alien Registration No. _______________________
Registering for:
Undergraduate Course(s)
Graduate Course(s)
If you will be applying these courses toward a degree, it is your responsibility to make sure that
the courses are approved to satisfy your degree requirements.
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COURSE REGISTRATION FORM (University of Wisconsin - Stevens Point)

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Completed 24 July 2020

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