Instructions for STUDENT completing this form
Enter the nine-digit OSIS Number as it appears on your permanent record and program card. No registration will be
entered without this number.
Enter your last name (surname or family name) - one letter per box.
Enter the city name used by the Postal Service (eg. Bronx, Brooklyn, New York, Staten Island, Flushing, Long Island
City, Richmond Hill, etc.)
Enter the two letter Postal Service abbreviation (eg. 'NY')
Enter the five-digit ZIP code used by the Postal Service.
Enter your home telephone number - area code first.
Enter your date of birth by using the following format - two digits for the month, two digits for the day, and two digits for
the year. (eg. September 30, 1984 would be entered as 09/30/84; April 3, 1984 would be entered as 04/03/83).
Student OSIS ...................................
Last Name ........................................
Enter the your first name (given name) - one letter per box.
First Name .......................................
Enter the building number and name of street or avenue where you live. Skip one box between number and street or
avenue.
Street Address ................................
If appropriate, enter the apartment number.
Apartment # ...................................
City ...................................................
State .................................................
ZIP ....................................................
Home Phone ....................................
Date of Birth ....................................
Enter an 'M' for male or an 'F' for female.
Sex ...................................................
Answer both questions to best describe your race/ethnicity.
Race/Ethnicity..................................
Answer your parent or guardian's highest level of education to the best of your knowledge.
Parent/Guardian Highest Level of
Education.........................................
Answer the student's current U.S. citizenship status.
Citizenship Status............................
Should be pre-printed on the form already. If not, enter the 4 digit ETS code for the High School
HS ETS Code ..................................
Should be pre-printed on the form already. If not, enter the High School Name
High School ...................................
USE CAPITAL LETTERS FOR ALL ENTRIES !
Check the year and semester that you entered the 9th Grade.
If you entered 9th Grade between Feb. & Aug. check 'Spring' - if you entered between Sept. & Jan. , check Fall.
Year Entered 9th Grade...................
Instructions for completing "COLLEGE CREDIT or NON-CREDIT COURSE Information"
Use most recent College Catalog Course Number. Iinclude number of credits (eg. '3.0' or '4.5' or 0.0) and whether this course is a waiver-funded course.
Check the appropriate box for the location of where the course is being offered.
Check the appropriate box for the primary affiliation of the instructor.
Instructions for STAFF completing this form
USE CAPITAL LETTERS FOR ALL ENTRIES !
Use the College Now Precollege Activities Registration Form if student is enrolled in a CN Foundation course, CN course, or CN
workshop this semester.
Should be pre-printed on the form already. If not, please enter both the name and phone number
College Contact & Phone ...............
Do not include section numbers.
Use the SAME form only if student is enrolled in a SECOND college credit or non-credit course this semester.
You MUST submit a separate form for each semester even if the student was enrolled in the prior semester.
Enter your e-mail address. Be sure to distinguish between letters and numbers when necessary.
E-mail Address.................................
Enter your cell phone number - area code first.
Cell Phone .......................................
Please enter your fax number-area code first.
Fax....................................................
Past CN Participation......................
Check 'Yes' if you participated in a CN Program before.
