DEPARTMENT OF EDUCATION

Special Admission/Registration Form

Date:

Student ID Number:

Last Name:

First Name:

Middle Initial:

Street Address:

City:

State:

ZIP Code:

County of Residence (if Kansas):

Email Address:

Phone Number  Home or Cell:

Social Security Number:

Date of Birth:

Gender:

Citizenship Status:

Session:  Spring Year:  2025   Location:  Off-site

Course Number                 Title of Course 

ED 610                                 Contemporary Issues in American Education

Credits

Total Hours Enrolled:

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The maximum number of hours that may be taken at the University of Saint Mary with “special student” status is 15.  Those who wish to pursue academic work beyond 15 hours must petition to have their status changed either to degree-seeking or to regular non-degree status.  At that time, transcripts of previous college work must be submitted to the Registrar.

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I hereby make application for special admission to the University of Saint Mary for the term: Fall 2024

Applicant's Signature:

Date:

****NO COST TO PARTICIPANT     Total due: $ 0  

The University of Saint Mary does not discriminate on the basis of race, creed, color, national origin, handicap, or sex in the consideration of eligible students for admissions, scholarships, awards and financial aid.