Summer 2017 Registration Form for NON-KU Undergraduate Students


THIS REGISTRATION FORM IS INTENDED FOR USE BY STUDENTS WHO ARE NOT CURRENTLY ENROLLED IN KUTZTOWN UNIVERSITY.

Please see the Student Accounts page for Tuition, Fees, and Payment information. Registration and course enrollment is NOT complete until payment is made in full. You will receive additional information (including account information) and instructions on how to make payment.

Do you hold a degree from a 4-year school?

If you checked yes, please contact Graduate Admissions to register as a Professional Credits Student.

 

General Information:

 
First Name Middle Name
Last Name Maiden Name
Street Address 1
Street Address 2
City    State    Zip Code
County
Email Address
Home Phone Cell Phone
Date of Birth:       Gender
PA Resident:
U.S. Citizen: Social Security #:
(Optional)
If No, Country of Citizenship:  
Name of High School if currently attending:
 
Kutztown University is committed to assuring equal opportunity to all persons regardless of race, color, religion, national origin, ancestry or gender. This policy extends to employment within and admission to the University and is compliance with all federal laws, including Title IX of the Educational Amendments of 1972.
What is your ethnicity?
What is your race? (Mark one or more races to indicate what you consider yourself to be.)
 



 

Emergency Contact Information:

First Name Last Name
Phone Relationship
 

Summer Session I 2017 (Wed., May 31 – Thurs., June 29) and
10 Week Session (see course description for begin/end dates)

Please note: there is a nine (9) credit maximum per session except for internships.

Housing If Yes, please contact the Housing Department in Old Main 106.
Meal Plan
Department Course
Number
Section
Number
Course
Title
Credits
   
   
   
   
 

Summer Session II 2017 (Mon., July 10 – Thurs., Aug. 10)

Please note: there is a nine (9) credit maximum per session except for internships.

Housing If Yes, please contact the Housing Department in Old Main 106.
Meal Plan
Department Course
Number
Section
Number
Course
Title
Credits