Fillable REGISTRATION FORM P (University of Alaska - Fairbanks)

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REGISTRATION FORM P (University of Alaska - Fairbanks)

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P
REGISTRATION FORM
RECEIVED
Oce use only
PRIOR EDUCATION INFORMATION
Did you graduate from high school?
qYes Graduation date? (MM/DD/Year): Name of high school:
High School location: (city/state):
qNo If NO, did you complete the GED? q Yes q No
Date GED completed? (MM/DD/Year): Location of GED (state):
Previous names used at the University of Alaska:
COURSE INFORMATION (Complete all information requested below. Refer to the class schedule on UAOnline for course information)
CRN Dept.
Course
Number
Section Course Title
# of
Credits
“Yes”
if
Audit
Instructor Signature
(required after last day of late registration)
I understand I am responsible for all applicable UAF academic regulations, tuition and fees whether or not I successfully complete the
course or courses in which I am enrolling. The university may drop me for non-payment.
4
I promise to pay attorney’s fees and other reasonable collection costs necessary for the collection of any amounts owed UA. If I do not
pay, the university may take my Permanent Fund Dividend under Alaska Statutes 14.40.251 and 43.23.073.
Student’s Signature Date:
Advisor’s Signature (for degree-seeking students only): Date::
Page of
Oce use only
Processed By: Date:
Oce of Admissions and the Registrar
907-474-7500 • 800-478-1823
admissions@uaf.edu • registrar@uaf.edu
10/2016
NAME: UA ID (or SSN):
Please print (Last) (First) (M I)
SEMESTER OF ENROLLMENT: Year 20 q Fall q Spring q Summer Date of Birth (MM/DD/YYYY):
CURRENT MAILING ADDRESS: Phone:
Cell Phone:
Email Address:
(City) (State) (Zip)
DEMOGRAPHIC INFORMATION:
Your response helps us better serve students and impacts UAF’s eligibility for some funding sources. See reverse side for information and codes.
Sex: qMale qFemale qPrefer not to answer Ethnicity: q Hispanic or Latino q Not Hispanic or Latino    
Race
1
:      Vet/Military Status
2
:
US Citizen? q Yes q No If no, Nation of birth: Nation of citizenship:
     Visa Type:          Permanent Resident?  q Yes  qNo
For instructions on withholding directory information, please see INFORMATION RELEASE on reverse side
3
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1
RACE*
Code Description
AA Alaska Aleut
AE Alaska Eskimo, Other/Unspecified
AH Alaska Indian, Haida
AI Alaska Indian, Other/Unspecified
AK Alaska Indian, Tlingit
AM Alaska Indian, Tsimshian
AN Alaska Native, Other/Unspecified
AQ Alaska Eskimo, Inupiaq
AS Alaska Native, Southeast
AT Alaska Indian, Athabascan
AY Alaska Eskimo, Yup’ik
BL Black, Non-Hispanic
IN American Indian (Not Alaska Native)
NH Native Hawaiian or Other Pacific Islander
SI Asian
UN Unspecified
WH White
* Requested for compliance with Title IV of the Civil Rights
Act of 1964.
2
VETERAN/MILITARY STATUS
Code Description
Blank Non-veteran
FMAI UAF Air Force Student
FMAR UAF Army Student
FMCO UAF Coast Guard Student
FMDP UAF Military Dependent
FMIL UAF Military Student
FMMA UAF Marine Corps Student
FMNA UAF Navy Student
FVDP UAF Veteran Dependent
FVET UAF Veteran Student
Oce of Admissions and the Registrar,
102 Signers’ Hall • PO Box 757480, Fairbanks, Alaska 99775
800-478-1823 • 907-474-7500
admissions@uaf.edu • registrar@uaf.edu
3
INFORMATION RELEASE
FERPA
The Oce of Admissions and the Registrar is responsible for
keeping student education records. The full copy of the university’s
policies regarding access to student records under the Family
Educational Rights and Privacy Act of 1974 (FERPA) are available
at www.alaska.edu/studentservices/ferpa/.
Directory Information
The university may release certain directory information to the
public on a routine basis unless a student requests, in writing,
that the university not release it. Forms to request that directory
information not be released are available in the Oce of
Admissions and the Registrar.
No directory information will be released until the last day of late
registration. Any request to withhold directory information will
continue until a student provides permission, in writing, for the
university to release such. After that, information will be released
when appropriate. The names of students who have requested
their directory information be withheld will not appear in the
published university chancellor’s and dean’s lists.
The following is considered directory information:
1. Name
2. Email address
3. Home city and state
4. Weight and height of students on athletic teams
5. Dates of attendance at UAF
6. Program/major field(s) of study
7. Degrees and certificates received, including dates
8. Participation in ocially recognized university activities
9. Academic and co-curricular honors, awards and scholarships
received, including dates
4
LATE PAYMENT/REINSTATEMENT FEES
An additional $100 fee will be added to accounts which are not
paid by the withdrawal deadline. The university may drop you for
non-payment.
For more information about fees, contact the Oce of the Bursar
at 907-474-7384.
Bristol Bay Campus
Fax: 907-842-5692
Chukchi Campus
Fax 907-442-2322
Interior Alaska Campus
Fax: 907-474-5208
Kuskokwim Campus
Fax: 907-543-4527
Northwest Campus
Fax: 907-443-5602
TO SUBMIT THIS FORM:
Fairbanks Campus
Email: registrar@uaf.edu
Community and Technical College
Email: uaf-ctc@alaska.edu
CRCD Fairbanks Oce
Fax: 907-474-6280
Submit in person or transmit to your campus:
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REGISTRATION FORM P (University of Alaska - Fairbanks)

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Completed 24 July 2020

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