NEW students must complete all sections – returning students skip section two
SECTION I – Student Information Check if you are: an employee employee’s dependent
Student Name: ___________________________________________ Student A#: _____________________
(Print Full Name) (Include the A00)
Have you previously taken classes here? Yes No Are you degree seeking? Yes No
If Yes:
Full name while previously in attendance: _____________________________________________________
Email: ________________________Advisor:_____________________ Phone: (_____) ______-__________
*Once active the Registrar’s Office sends correspondence to Norwich University student email accounts not personal accounts.
SECTION II – New Student Information Student SS#:______________________________
(If Applicable)
Permanent Address: _______________________________________________________________________
The following responses are voluntary, kept confidential and are not used for admissions purposes. This
information is necessary to provide data for federal regulations.
Date of Birth (mo/dy/yr): ____________________ Gender: M F
Race/Ethnicity: African American Asian Multiracial
Native Hawaiian/Other Pacific Islander White-Non-Hispanic Non-Resident
American Indian/Alaskan Hispanic or Latino
Citizenship: U.S. Citizen International Student Asylee
Resident Alien (US Permanent Resident) Undocumented Refugee
SECTION III – Course Information Year: _____Semester: Fall Spring
If a deposit is required please see the Bursar’s office. Registration for courses requiring a deposit are not
processed without the Bursar’s signature: ___________________________ ___________________________
Printed Name Signature
CRN# Subject Number Section Course Title Credits
______ ______ ________ ______ ________________________________________________ ______
______ ______ ________ ______ ________________________________________________ ______
______ ______ ________ ______ ________________________________________________ ______
SECTION IV – Signature (required) I agree to abide by all University Policies and Regulations:
_____________________________________ ______________________________________ __________
Student Name (Print) Student Signature Date
Date:
RGS: Registration Form Revised 04/2018
Course Registration Form
- For Non-Matriculating Students during Fall and Spring
Terms Only
-Summer Registration visit online.norwich.edu/summer
For Fall & Spring Non-Matriculating Student Registration Only - For Summer, visit online.norwich.edu/summer to register
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