School of the Art Institute of Chicago
Registration and Records
36 South Wabash Avenue, suite 1450
Chicago, IL 60603
Email: saic.registrar@saic.edu
Phone: 312.629.6700 Fax: 312.629.66701
Student-At-Large (SAL) Registration Form
STUDENT INFORMATION (PLEASE COMPLETE ALL FIELDS AND PRINT CLEARLY)
Address
Apartment
City
STUDENT GENDER:
Date of Birth (MM/DD/YYYY)
State
Degree DegreeGrad Year Grad YearUndergrad School Attended Grad School Attended
Primary Phone: Secondary Phone:
Year: 20
Zip Code
Primary Email Address (confirmation will be sent here)
Last Name First Name Preferred Name MI ID # (if returning)
FemaleMale
Fall Spring Summer
Signature required of student or parent/legal guardian if student is under 18 years of age.
Date
X
COURSE SELECTIONS
Class number Class dates Day(s) Meeting timesTitle
Class number
Class number
Class dates
Class dates
Day(s)
Day(s)
Meeting times
Meeting times
Title
Title
Class number Class dates Day(s) Meeting timesTitle
OPTIONAL
Yes NoDo you consider yourself to be Latino/Hispanic?
In addition, select one or more of the following racial categories to describe yourself:
How did you learn about the Student-at-Large Program at the School of the Art Institute of Chicago?
Native American Asian WhiteBlack or African American Native Hawaiian
Friend I am a returning studentSAIC Website Teacher
Other
Mobile Home Work Mobile Home Work
CONTINUING STUDIES ACKNOWLEDGMENT + AGREEMENT
I understand that I am financially responsible for the course(s) for which I am registering.
I give SAIC permission to obtain emergency medical care, hospital, or clinic treatment for me. I hereby waive liability against SAIC for such care and for
transportation provided to such care and for transportation provided to such locations as deemed necessary by SAIC.
I have read and agree to abide by the student Rights and Responsibilities for Students-at-Large and CreatiVets, available online at saic.edu/ace > Forms and
Downloads.
I agree to the forgoing on behalf of myself/my child or ward.
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•
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PARENT/GUARDIAN INFORMATION (All fields required)
EMERGENCY CONTACT INFORMATION
(Additional contact other than primary required)
Relationship to student Relationship to student
Email Address
Phone:Phone:
Email Address
Last Name Last NameFirst Name First Name
Mobile Home Work
Mobile Home Work
click to sign
signature
click to edit
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