2010 High School Enrollment Form
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2HIGH SCHOOL ENROLLMENT FORM
Barcode label
Office use only
RECEIVED
RESET
SID label
office use only
PRINT
P
Office use only
Term ____________
To enroll at UAF while still a high school student, you must
semester you are enrolled. NOTE: Permission to enroll in
Complete this form.
a course must be obtained each time you register.
l
Meet prerequisites of the course or courses in which you
If you want to use university credit to meet high school
l
l
want to enroll.
requirements, contact your high school counselor before
Get permission from the instructor or the department
you enroll at UAF.
l
head.
Students may choose not to release their directory
l
Submit the completed form to the Office of Admissions
information by completing a “request to withhold or
l
and the Registrar during the regular registration period
release directory information” form, available at the
Pay tuition and fees by the last day of fee payment in the
Office of Admissions and the Registrar.*
l
NAME:
UA ID (or SSN):
(Last)
(First)
(M I)
SEMESTER OF ENROLLMENT:
Year 20_____ Fall Spring Summer Date of Birth (
):
MM/DD/YYYY
CURRENT MAILING ADDRESS:
Day Phone:
Evening Phone:
Email Address:
(City)
(State)
(Zip)
1
Residency
: Students seeking Alaskan residency or a waiver of non-resident surcharge must complete an “Application for Resident
Tuition” or “Waiver of Non-Resident Surcharge” and provide required documentation to the Office of Admissions before the published
first day of instruction (UA Board of Regents RegulationR05.10.05). See reverse side for information.
DEMOGRAPHIC INFORMATION: See reverse side for information and codes.
2
3
Sex: Male
Female
Ethnicity
:
Vet/Military Status
:
4
For instructions on withholding directory information, please see FERPA on reverse side
.
US Citizen? Yes No If no, Nation of birth:
Nation of citizenship:
Visa Type:
Permanent Resident? Yes
No
PRIOR EDUCATION INFORMATION:
Name of high school you are attending:
Location (city/state):
Expected graduation date? (
MM/DD/YYYY):
COURSE INFORMATION (Complete all information requested below. Refer to the Class Schedule for course information)
CRN
Dept.
Course
Section
Course Title
# of
“Yes”
Instructor Signature required
(permissions rec’d thru UAF e-mail account
Number
Credits
if
from instructor or dept head is acceptable)
Audit
I understand I, or my parent, are responsible for all applicable UAF academic regulations, tuition and fees whether or not I successfully complete
the course or courses in which I am enrolling
. The university will not initiate a drop for non-payment
.
5
5
Student’s Signature:
Date:
Parent’s Signature:
Date:
OFFICE OF ADMISSIONS AND THE REGISTRAR ONLY:
Processed By:
Date:
Page
of
OFFICE OF ADMISSIONS & THE REGISTRAR l PO BOX 757480, FAIRBANKS, AK 99775-7480 TEL: l 907-474-7500 / 800-478-1823 l FAX: 907-474-7097
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