Senior Citizen Guest Policies
Senior Citizen Guest Form
Please Note:
·Senior Citizen Guests must be 62 years of
age or older to be a guest in a course at no
·Senior Citizen Guests may be a guest in
only one (1) course per term.
·Senior Citizen Guests sit in on the traditional
lecture courses. Participation is not permitted
in laboratories or other non lecture course
·Tuition paying students receive first
priority. Classes with full enrollment or
individualized instruction classes are not
available for Senior Citizen Guests
·Do not submit this form to the faculty
member teaching the course until after the
first day of classes.
·Books - The purchase of any books is the
responsibility of the Senior Citizen Guest.
The University Bookstore is located in
McIntosh Center, (419) 227-2410.
·When this form is completed and signed by
the faculty member teaching the class, return
the form to the Registrar's Office for
processing, and notification of the faculty
Registrar’s Office
Ohio Northern University
525 South Main Street
Ada, OH 45810
(419) 772-2024
This is a fillable form--you can type information into the blanks before printing.
Last Name, First Name, Middle
Course Section
Faculty Teaching
Days and Time
Zip Code:
Phone Number:
Email Address:
Date of Birth:
Signature Date
Faculty Signature
Fall Spring Summer
Rev. 10/7/13
American Indian or
Alaskan Native
Please select one or more of the following racial categories to describe yourself.
Black or African
Native Hawaiian
or Pacific
White Hispanic/Latino
Print Form