SAINT JOSEPH'S UNIVERSITY
UNIVERSITY COLLEGE

2008 INTERSESSION REGISTRATION FORM

Register early....classes fill quickly.

(Check one)
____ Saint Joseph's University College (Evening/Bridge) Student or ____ Alumnus

____ Saint Joseph's Day Student (if using course as a major course, you must have permission from department chairperson; if using course as a general elective, you must have permission from your advisor.)

____ Student attending another college (Please complete a Visitor Form)

Student I.D.# or Social Security #___________________________________________________

Name(Last)________________________________(First) ________________________(MI)____

Address_________________________________________________________________________

___________________________________________________________________________

Home Phone (______)________________________ Cell Phone (______)___________________

Business Address_________________________________________________________________

Business Phone(______)______________________ E-Mail Address_______________________

 

Optional (for statistical purposes only):

Sex: M_____ F_____ Race:___________ Citizen:________ Birth date ________________

COURSE SELECTION

CRN	Dept	Number	Title
_____	_____	______	______________________________________	(first course selection)
_____	_____	______	______________________________________	(alternate course)

 

 

 

 

Student's Signature______________________________ Date____________________

Advisor's Signature______________________________ Date____________________

I authorize the use of my credit card account: (check one) ___ MasterCard ___ Visa ___Discover ___American Express (in person only)

Card No._________________________________ Exp. Date____________

Register in person, by mail (Student Service Center, Saint Joseph's University, 5600City Ave., Philadelphia, PA 19131) or by fax (610-660-1019).