Fillable REGISTRATION FORM Spring Summer Regular (Fall/Winter) (Brandon University)

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REGISTRATION FORM Spring Summer Regular (Fall/Winter) (Brandon University)

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The REGISTRATION FORM Spring Summer Regular (Fall/Winter) (Brandon University) form is 1 page long and contains:

  • 6 signatures
  • 23 check-boxes
  • 146 other fields

Country of origin: CANADA
File type: PDF

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(03/20)
REGISTRATION FORM
Last Name
Student Number
First Name (s)
Former Last Name (if applicable)
Current Mailing Address
For Office use only:
Regular
Probation
Mature
Auditor
Transfer
Dual Credit
Visitor
Rec’d by: _____
Ent’d by: _____
Last Reg Session: _____
City/Town
Province
Session (check one):
Spring Summer Regular (Fall/Winter)
Postal Code
Phone Number
Academic Year:
Are you sponsored by an Agency? Yes No
Birthdate
Social Insurance No.
(for tax receipt purposes)
If yes, provide name:
Current Degree Program
Do you identify as a Canadian Indigenous person? (optional) Yes No
First Nations Metis Inuit Non-Status Unspecified Group
Courses/Labs Added
Courses/Labs Dropped
Dept
Course
Sect
Lab
Title
Term
Dept
Course
Sect
Lab
Title
Term
It is the student's responsibility to ensure that all prerequisite, major/minor, degree & graduation requirements are met. Another person may not
complete a registration on behalf of student. Refunds for courses dropped after commencement of classes will be pro-rated. Courses
added/dropped after approved dates and/or individual cap raises require three signatures as below.
Check if Complete Withdrawal
from all courses
I certify that all information is correct, complete and true. I acknowledge that I have read, understand and agree to the use of my personal information as described under
Personal Information Collection and Disclosures
.
Student’s Signature: ___________________________________________________________________ Date: ____________________________________________
For Internal Use Only
Check all that apply: Course(s) added outside approved dates (tuition must be paid with registration)
Course(s) dropped outside approved dates – Authorized Withdrawal (AW) assigned
Individual cap raise for course # _______________________________
Overload approved for Term One Term Two (requires Dean’s approval only)
Instructor’s Signature: __________________________________ Date: ___________________________
Chair’s Signature: ______________________________________ Date: ___________________________
Dean’s Signature: ______________________________________ Date: ___________________________
Advisor Approval (if applicable)
_____________________________ _____________
Signature Date
Departmental Approval (if applicable)
[Health Studies, Education, Music, MRD, PENT, etc.]
_____________________________ _____________
Signature Date
Submit completed form to Financial & Registration Services, 2
nd
Floor, Clark Hall, 270-18
th
Street, Brandon MB R7A 6A9
Phone: 204-727-9724 or 204-727-7313 Fax 204-726-4573 Email: finreg@brandonu.ca
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REGISTRATION FORM Spring Summer Regular (FallWinter) (Brandon University)

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Completed 30 January 2021

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