ARCHIVED - Reg Form - Intersession and Spring 2013

ARCHIVED - Special Student Registration Form - Intersession and Spring 2013
Full Name

First NameLast Name
Gender
Ethnicity
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Social Security Number
(for tax purposes) numerals only; no dashes
Birth Date

MonthDayYear
Institution of Affiliation
INTERSESSION courses you'd like to take
SPRING SKSM courses you'd like to take
SPRING IBS Courses you'd like to take
Number of Units
located on SKSM.edu course listings page for your course
Pin Required
PIN #
6 digit number received from faculty member. if your course does NOT require a PIN please enter 000000
Grade Type
Moodle ID Status
Enter Code Here
For Office Use Only
Term
Course
Professor
Amount Due
Amount Paid
Check Number
Check Date
Should be Empty:

ARCHIVED - Special Student Registration Form - Intersession and Spring 2013