NONDEGREE-SEEKING COURSE ENROLLMENT FORM

How to use this form.

Page 1 of 2 - Course Enrollment Form

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Does the course or courses, in which you wish to register, require prerequisites? Need to check for prerequisites? Search the class schedule. *

Does the course or courses, in which you wish to register, require prerequisites? Need to check for prerequisites? Search the class schedule. Yes No
Do you meet the prerequisites for the courses in which you are attempting to register? *

Do you meet the prerequisites for the courses in which you are attempting to register? Yes No
If you don't meet the prerequisites:

Request permission to register in the course from the instructor of the course. If you have received a prerequisite waiver from the instructor or department, please forward it to RegServices@MissouriState.edu with the subject line “Your Name Prerequisite Waiver”
Does the course or courses, in which you wish to register, have open seats? If unsure, search the class schedule. *

Does the course or courses, in which you wish to register, have open seats? If unsure, search the class schedule. Yes No
If the course is closed:

Contact the instructor of that course to request permission to enroll in a closed course. Once you have obtained permission, please forward that email to RegServices@MissouriState.edu with the subject line “Your Name Course Permission”
Are you planning to complete over 16 hours (fall or spring) or 10 hours (summer) in graduate (300 or above) level courses or 18 hours (fall or spring) or 10 hours (summer) in undergraduate (299 or below) level courses? *

Are you planning to complete over 16 hours (fall or spring) or 10 hours (summer) in graduate (300 or above) level courses or 18 hours (fall or spring) or 10 hours (summer) in undergraduate (299 or below) level courses? Yes No
You will need to request overload permission:

Complete an overload permission form and submit to RegServices@MissouriState.edu with the subject line “Your Name Overload Permission”
Is your current balance with the University under $200? *

Is your current balance with the University under $200? Yes No I don't know
If your balance is over $200:

Contact Accounts Receivable to verify and pay your balance. This is required to move forward with your registration.
APPLICATION FOR ADMISSION
For which semester are you applying *
Legal Name Legal Name * First Last
Alternate name(s) that you have used previously (if applicable).
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone * - ### - ### ####
Email address *
Have you attended Missouri State University previously?

Have you attended Missouri State University previously? Yes No
Please provide your BearPass ID (also known as M Number) if known.
Sex *

Sex Male Female
Date of birth Date of birth * / MM / DD YYYY
Highest diploma or degree earned *

Highest diploma or degree earned Master's or higher Bachelor's Associate's High School GED
School or college at which you earned the above diploma or degree(s):

Include name of school or college and state.
Are you seeking teacher certification at MSU?

Are you seeking teacher certification at MSU? Yes No
Have you lived in Missouri the past 12 months for purposes other than being a student? *

Have you lived in Missouri the past 12 months for purposes other than being a student? Yes No
In which state are you a resident?
Are you a U.S. citizen? *

Are you a U.S. citizen? Yes No
Are you a permanent resident? *

Are you a permanent resident? Yes No
If you are not a U.S. citizen or permanent resident, indicate your Visa type (e.g., B-1, H-1) and the country issuing your passport:
Maximum of 1000 characters allowed. Currently Entered: 0 characters.
Ethnicity: The following race and ethnicity questions are requested to assist the University in complying with Federal guidelines (these questions are optional).

Ethnicity: The following race and ethnicity questions are requested to assist the University in complying with Federal guidelines (these questions are optional). Hispanic or Latino Non-Hispanic or Latino

The following race and ethnicity questions are requested to assist the University in complying with Federal guidelines (these questions are optional).
Race: The following race and ethnicity questions are requested to assist the University in complying with Federal guidelines (these questions are optional).

Race: The following race and ethnicity questions are requested to assist the University in complying with Federal guidelines (these questions are optional). American Indian or Alaska native Asian Black or African American Native Hawaiian or other Pacific Islander White or Caucasian

The following race and ethnicity questions are requested to assist the University in complying with Federal guidelines (these questions are optional).
Have you ever been convicted of, or pled guilty to, a crime (other than a misdemeanor traffic offense); are any criminal charges pending against you; or have you been dismissed/suspended from another college or
university for disciplinary reasons? *

Have you ever been convicted of, or pled guilty to, a crime (other than a misdemeanor traffic offense); are any criminal charges pending against you; or have you been dismissed/suspended from another college or
university for disciplinary reasons? Yes No
If you answered yes to the the 'Disciplinary action' question, please explain.
Maximum of 1000 characters allowed. Currently Entered: 0 characters.
Please check the item that best describes your most recent military status: *

Please check the item that best describes your most recent military status: No affiliation Active duty Reservist National Guard Veteran Miliary dependant Prefer not to answer
Please check the item that best describes your most recent branch of service: *

Please check the item that best describes your most recent branch of service: No affiliation Air Force Army Coast Guard Marine Corps Navy Prefer not to answer
Missouri State University (MSU) collects this information to enroll you into the university and to comply with federal and state law. Unless required by US law or authorized by university policy, MSU will not share your
personal information. Any sensitive information, including past disciplinary or criminal actions, is used only for internal review purposes.
COURSE REGISTRATION

Please indicate the course(s) for which you wish to register below. If we are unable to register you into the class you request, we will email you at the address you provided above to let you know and to assist you with alternate arrangements.
See the Class Schedule or course information and appropriate CRN. Example: CRN #40681, ACC 201 001, 3 credit hours
Maximum of 1000 characters allowed. Currently Entered: 0 characters.

NONDEGREE-SEEKING COURSE ENROLLMENT FORM

NONDEGREE-SEEKING COURSE ENROLLMENT FORM

Page 1 of 2 - Course Enrollment Form

If you don't meet the prerequisites:

If the course is closed:

You will need to request overload permission:

If your balance is over $200:

APPLICATION FOR ADMISSION

COURSE REGISTRATION