NEW GRADUATE STUDENT REGISTRATION FORM
Office of the Registrar Nazareth College 4245 East Avenue Rochester NY 14618
Smyth Hall Room 1 Phone: 585-389-2819 Fax: 585-389-2612 Email: registrar@naz.edu
Complete the information below and return this form in person, by mail, fax, or email.
Last Name: _______________________________________ First Name: ___________________________ Status: I am a new student in a graduate degree program
Nazareth ID# (or Soc. Sec. #): __________________________
__ *
Note: Non-matriculated students will need to complete the Non-Matriculated Student Form
Start Term: Fall Spring Summer Year_________ Academic Program: __________________________________________________________________
Ad
dress: ____________________________________ City/State/Zip:____________________________________ Email: _________________________________________
Home Phone: ________________________________ Cell Phone: ______________________________________ Work Phone: ____________________________________
U
For federal reporting purposes:
U
Date of Birth: ______/______/______
1. What is your ethnicity? Hispanic or Latino Not Hispanic or Latino
2. What is your race? Mark one or more races to indicate what you consider yourself to be.
White Black or African American Asian American Indian or Alaska Native Native Hawaiian or Other Pacific Islander
_
_____________________________________________________________ _________________________________________________________________________
Student Signature/Date Advisor Signature/Date (
required)
*Students starting in the summer should list all summer and fall coursework
Preferred Course Selections
Alternate Course Selections
Course Number
(ex: SPF 501 30)
(To be used if preferred
sections are closed)
OFFICE USE ONLY
Processed by: _________________
Date: ________________________
Please Note:
Billing information is accessible via NazNet.
You must register for at least 6 graduate credits to qualify
for student loans. Contact the Financial Aid Office with
questions: (585) 389-2310 or finaid@naz.edu.
