Alvernia
Division of Graduate Studies
 
Alvernia Home Summer Term Home CoursesCalendarRegistrationTuition & Fees

Alvernia Student

Summer Term 2008

Registration

Graduate     Undergraduate

PERSONAL DATA
Prefix:   
First Name:
Last Name:
Middle:
Suffix:
Date of Birth:
Social Security Number: (e.g. xxx-xx-xxxx)
Address:
City:
State:
Zip:
Country:
Email Address:
Home Phone Number: (e.g. (xxx) xxx-xxxx)
Work Phone Number: (e.g. (xxx) xxx-xxxx)

COURSE SELECTION
Course 2:
Course 3:
Course 4:
Course 5:

OPTIONAL INFORMATION
Gender Ethnic Origin Marital Status Religion
Male American Indian or Alaskan Native Single Islam
Female Asian Married Jewish
  Black/African American Divorced Protestant
  Separated  
  Native Hawaiian or Other Pacific Islander Widowed   Lutheran
  White/Caucasian     Presbyterian
  Two or More Races     UCC
  Other:     United Methodist
        Other Protestant
      Roman Catholic
      Other:

SIGNATURE
To the best of my knowledge, the above information is true.
I agree that, if accepted, I will comply with the rules and regulations of Alvernia College.

Signature: Date:

* I acknowledge and accept the tuition and fees, as published in the applicable catalogue that will be incurred by this registration request.

Alvernia College complies with all federal, state, and local nondiscrimination laws in the administration of its educational programs and services and in its employment relationships.

or


Contact the Graduate and Continuing Studies Division with any questions: (610) 796-8228

Alvernia College · 540 Upland Avenue, Reading, PA 19611· 1-888-ALVERNIA · gradandce@alvernia.edu