Senior Auditing Program Registration Form

Summer 2008

Please fill in all the information below completely. It is very helpful to us when registering you.

* = Required Field

First Registrant

Full Name:*

Last Four Digits of Social Security Number:*

Date of Birth:* (mm/dd/yyyy)

For example: April 21, 2008 would be 04/21/2008

Email Address:*

Street Address:*

Street Address 2/Apt.

City:*

State:*

Zip Code:*

Home Phone:*

Alternate Phone :

Fill out table below with your course selections (and alternatives).*

Course Choices	Department	Course # & Section #	Course Title	Instructor
Example Only	PSCI	281-001	Intro to American Law	Jefferson
1st Course
1st Alternative
2nd Course
2nd Alternative

Only list a second course if you intend to take two courses.

If you are only registering for yourself, please skip the next section and press the “Submit” button at the bottom of this form. If there is more than one registrant, please continue to fill in the information below then press “Submit”.

Second Registrant

Full Name:

Last Four Digits of Social Security Number:*

Date of Birth: (mm/dd/yyyy)

For example: April 21, 2007 would be 04/21/2007

Email Address:

Street Address:

Street Address 2/Apt.

City:

State:

Zip Code:

Phone:

Alternate Phone:

Fill out table below with your course selections (and alternatives).*

Course Choices	Department	Course # & Section #	Course Title	Instructor
Example Only	PSCI	281-001	Intro to American Law	Jefferson
1st Course
1st Alternative
2nd Course
2nd Alternative

Only list a second course if you intend to take two courses.