Sample Registration Approval Form For On-Campus Admitted Students


On-Line Course Work Only
Registration Approval for On-Campus Admitted Students
~NOTE: This Form is not required For SUMMER Courses~
I am requesting permission to register for:
Course #
Course ID
BSU ID #: ____________________________
Course Title:
Phone: _________________________
Fall ___
Spring ___
STATUS: (check one)
Will you be enrolled in on-campus (face-to-face)
FR. ___ SO. ___ JR.___ SR. ___ GRAD ___
classes this term? ___ How many credits? ____
**Seniors Only**
Full Time ___
Part time ____
Have you submitted Grad Plans to the Records
Number of Credits completed to date: ____
Office? Yes__ No__
Your Major: _________________________
If yes, have they been approved? Yes__ No__
Your Minor: _________________________
I am requesting this online course instead of attending an on-campus course because (check all that apply):
Internship/Student Teaching/Study
Course Not Offered On Campus This Term
Health Problems
Employed ____ Number of Hours Per Week
Course Schedule Conflict
Work Schedule Conflict
Planning to Graduate within One Semester
Child Care Responsibilities
Athletic Team Practice Schedule
Personal / Family Crisis
Preference for Online to On-Campus Courses
Distance from Campus: (# of Miles) ______
By signing below I understand that, if all approvals are received:
- Approval requirements vary by department.
- Forms are processed on a designated date each term (or as received if after the designated date).
- An approved form does not guarantee a seat in the course if the course is full.
- If seats are available, the Records Office will register me for the course.
- Once this form is processed, you will receive an email from the Records Office.
Students Signature: ______________________________
Date: ________________________
_______ Advisor: ___________________________________ Date______________________
_______ Instructor:__________________________________ Date______________________
_______ Department Chair: ___________________________ Date______________________
_______ College Dean: _______________________________ Date______________________
Records Use Only:
____ Reg’d & Emailed Student
____ Denied by Faculty
____ Course Full; Override Added, Emailed Student
Rev. 12/02/2014


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