Student Name: _________________________________ Start Term: _____________
Student Email: __________________________________
(Ex. Fall 20_____ Spring 20_____)
Intended Major: ________________________________ Date: _____________
High School: ____________________________________
I would like to take classes _____ on-campus _____ online See Course Offerings at z.umn.edu/course-offerings
Class #
Course Title Credits
(for internal staff use only)
Notes:
High School Counselor Name: _____________________________________
High School Counselor Email: ______________________________________
High School Counselor Phone: _____________________________________
High School Counselor Signature: __________________________________ Date: __________________
Student Signature: ______________________________________________ Date: ___________________
UMN Crookston Advisor Signature: _______________________________ Date: ___________________
Any changes made to the above course registration should be discussed with an academic advisor in the Student Success Center: (218) 281-8580
List 1-2 alternate courses
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