SDUIS: Forms: Course Registration Form

Course Registration Form (111)

Please make sure to supply information in all required fields (*).

Student Information

Click if new student Click if student information has changed

*First Name

*Last Name

*Address 1

Address 2

*City *State/Prov

*Zip *Country

*Phone H:

*Phone W:

SSN

*Email

Enrollment Status:
I am an exclusive audit student (skip to 4)

Conditional Acceptance Degree Program Extension Student

Registration

*Quarter: *Year:

*Number: (eg: CPS655DL)	*Course Title:	*For:	*Location:

Payment Plan

For Pay As You Go Students (online and on campus):

The first tuition payment, (at least one third of the quarterly tuition), is due at the time of registration. The remaining two payments are due the 15th day of the following two months. This quarter you will not be invoiced for your second and third payments, so it is your responsibility to remember to make the following payments. A $5.00 Deferred Payment Plan Processing Fee will accompany each payment. Payments received after the 15th of the month will be charged a $50.00 late tuition payment fee. Please include the late fee with your payment.

Payment Information

Your registration will not be processed without a valid payment.

Payment Method
If paying with a credit card: I do I do not authorize automatic payment on the 15th of the second and third month.

Credit Card # Exp. Date:

Name on card

*Total Amount Paid: $

Please enter comments, remarks, or questions below, or call (858) 638-1999 (USA):

NOTE: You must drop a class before the fifth hour of instruction to avoid financial penalty. If you drop a class, you must notify the Registrar with a drop/add form, which may be obtained in the Administrative Office. Please be aware that you cannot drop a class by telephone. If a refund is due it will be computed based upon the last date of attendance unless the class has been taken as an audit class. When the class was enrolled on an audit basis the refund is based upon the date the drop/add form is received or postmarked, if mailed, as there is no attendance requirement for audits.