REQUIRED SIGNATURES
STUDENT INFORMATION
Registrars Office
Class Schedule Registration
PLEASE LIST COURSES:
PLEASE LIST ALTERNATIVES:
CRN
CRN
SUBJECT
SUBJECT
TITLE
TITLE
CREDITS
CREDITS
DAY(S)
DAY(S)
TIME
TIME
PREREQS MET
PREREQS MET
Please complete this form, sign, date and submit request in person to Registrar’s Office, SSC L157.
NEW AND TRANSFER STUDENTS must complete an application and go through the admission process prior to registering for courses. CONTINUING STUDENTS must
complete the form below and meet with your program advisor. For up-to-date course availability, access the schedule online on myCommNet.
First Name MI Last Name
Mailing Address City State Zip
Email Address Home Phone Number Work Phone Number
Advisor Signature Student Signature Date
Birth Date (Month/Day/Year) Banner ID Number
Note: It is the student’s responsibility to know and follow course prerequisites and corequisites.
Note: It is the student’s responsibility to know and follow course prerequisites and corequisites.
METHOD OF PAYMENT
Payment Information (please check only one):
n
MasterCard
n
Discover
n
Visa
n
Money Order
n
Cash (no cash by mail)
n
Check # _________________________
Signature of Cardholder Date Signed
Address of Cardholder (if different from above)
Credit Card Number
Please indicate method of payment below. Make checks payable to MCC.
Expiration Date
November 2017/PR
CVC Code
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