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1THE UNIVERSITY OF SOUTHERN MISSISSIPPI
Graduate School
Approval for Non-Degree Registration/Enrollment in a Graduate Course
______________________________________
___________________________
Last Name, First Name (include maiden or other names)
Student ID # or Social Security Number
______________________________________________
________________________________
E-mail address/ Phone #
Mailing Address
___________________________________________
________________________________
Non-Degree Graduate Hours Earned to Date
City/State/Zip
___________
____________
_________
____________
__________
___________
_________
Course Prefix
Course Number
Section
Registration Code
# of Hours
Term
Year
Non-Degree Status Being Requested:
1) _____Non-Degree not seeking admission
2) _____Non-Degree seeking admission to _________________for the ____________degree.
Department/school
master’s specialist doctoral
3) _____Non-Degree seeking Licensure in ____________________________.
4) _____Non-Degree seeking Certificate in ___________________________.
5) _____Non-Degree taking GCRL course.
6) _____Non-Degree taking STUDY ABROAD course in ____________________________.
Documentation Required:
_____ Yes, I have submitted or attached a completed Application to Graduate School
_____ Yes, I have attached Proof of Bachelor’s degree (diploma, transcript).
By signing this form below, I acknowledge that I understand the following conditions apply to
me as a non-degree seeking student:
1.
If I apply to a master’s or specialist’s program, a total of no more than nine (9) semester hours taken as non-
degree graduate student may count toward a master’s or specialist’s degree and that the department to which I
am admitted must approve the courses.
2.
No non-degree courses may be applied toward a doctoral degree. If I start the semester as a non-degree
student, I must be admitted to a doctoral program two weeks before the end of that semester in order for the
courses to count toward my degree.
3.
As a non-degree seeking student, I am not eligible for financial aid.
4.
By enrolling in this class, I agree to pay in full all tuition and fees associated with the class.
5.
th
If I withdraw online after 10
day of class, I will be charged full tuition and fees associated with the
class.
6.
For important dates, go to
7. If I wish to drop any of my graduate non-degree courses, I must call Graduate School at
601.266.5137 or come back to the Graduate School.
1. _______________________________
Approved: 2_______________________________________
Student’s Signature
Date
Department/School Chair
Date
3. ______________________________________
4. ______________________________________
Dean, Graduate School
Date
Entered People Soft: Graduate Admissions
Date
AA/EOE/ADAI
11/01/2009
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