Canisius College Undergraduate
Application and Registration Form
(Non-matriculating/non-degree and auditor applicants)
Non-degree and audit students are not eligible for any form of federal, state or institutional financial aid.
Directions to the Applicant:
Please clearly print and complete all information, and email the application and required documents to
Include a copy of your state issued driver’s license with picture.
If you are currently enrolled at another college/university, you must also submit an unofficial transcript with this application
to verify any possible course prerequisites.
Note: Students currently enrolled at another college or university should seek approval from that college prior to taking a
course at Canisius College.
By registering for classes, Canisius College is entitled to bill you for the appropriate tuition and fees. You become
responsible for payment of those tuition and fees.
Please check the selection that best applies:
Non-matriculating student Auditor: Alumni/parent of student Senior Citizen Other
Last Name First Name Middle Initial SSN
Month______Day_____Year______________________________________ Male__Female___________________________________
Date of Birth Gender
Current Address City State Zip
Primary Phone Number Secondary Phone Number E-mail Address
Have you ever been convicted of a felony or misdemeanor (excluding traffic violations)?
Yes No
If yes, details: ________________________________________________________________________________________________
Please list below the colleges and universities you attended:
Name of School
Date Entered
Date Left
Check if still
Course Selections
Subject/Course Number
Signature Date
Send the completed form and documentation to:
Student Records and Financial Services Center
Canisius College
2001 Main Street, Buffalo, NY 14208
or via email to
Approval Disapproval
Date: __________________________________________
Signature: __________________________________________