Request for Cross Enrollment in Adult Studies Courses for Traditional Students
Last Name: *
First Name: *
ID Number: *
NCWC email address:
Telephone Number: *
Age: *
Current Class Status: *
Grade Point Average: *
Expected Graduation Date: *
Major(s)/Minor(s): *
Course Number and Section Number: *
Reason for requesting enrollment: *
Academic Advisor Name: *
I have read and understand the following APS policies: *
Required
Please print your name below to serve as your signature that you are requesting approval to take the above course and have read the policies above: *
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