preview of fall 2008 course schedule - Immaculata University

COURSE REGISTRATION FORMYou may register Online as explained on page 5, or Mail this form to:Immaculata University or FAX the completed registration form to: 610-647-0215College of LifeLong Learningor Email your registration information to: cll@immaculata.eduP.O. Box 300or Walk into the offices of the College of LifeLong LearningImmaculata, PA 19345-0300on the Terrace Level of Good CounselFor Summer Full and Summer I: If registering on or before April 30, an invoice will be mailed to you with a full-payment-due date ofMay 12. If registering after April 30, payment-in-full or first installment must accompany your registration.For Summer II: If registering on or before June 23, an invoice will be mailed to you with a full-payment due date of July 7. Ifregistering after June 23, payment-in-full must accompany your registration. SUMMER 2008 FALL 2008 COURSE REGISTRATION FORMUniversity ID# SS# Date of Birth: □ Male □ FemaleMr.Ms.First NameLast NameStreet Address City State ZipHome Phone Cell Phone Work Phone Email addressPlease check one: U.S. Citizen Resident/Green Card Visa Status (Please specify)Purpose of Study at Immaculata University: Degree Program Teacher Certification Courses for Transfer Brandywine Nursing Program Enrichment School Nurse Certification Undecided Prerequisites for Graduate StudyCheck One: New Student Current CE Student Current ACCEL ® Student Senior Citizen I.H.M. SisterPlease indicate your ethnic background (optional, needed to satisfy government requests)African American American Indian Asian/Pacific Hispanic WhiteOFFICE USE ONLYComplete Information BelowCanceledCRN # Section # Course #/Title Credits Tuition Time Day IU StudentMy signature below confirms my intent to register for the course(s) above. I understand this registration will be processed unless I amnotified because (1) the course is full or cancelled, (2) I lack the proper prerequisites, or (3) I have an outstanding balance.Student SignatureToday’s DateOFFICE USE ONLYReceived by (): In Person Mail Email Fax Payment by (): Cash Check # Credit Card No PaymentEntered by: Enclosed is my check or money order made payable to Immaculata University. Charge my Credit Card. Type:Account Number:Name on card: Expiration Date: Amount charged to card: $47