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					                                                     High School Student Enrollment form
                                                                                                       Office of Admissions and the Registrar, 102 Signers’ Hall,
                                                                                                                       PO Box 757480, Fairbanks, Alaska 99775
                                                                                                    907-474-7500 (ph) • 907-474-7097 (fax) •

   To enroll at UAF while still a high school student, you must
     ƒ Complete this form.
     ƒ Meet prerequisites of the course or courses in which you want                      ƒ If you want to use university credit to meet high school require-
       to enroll.                                                                           ments, contact your high school counselor before you enroll at UAF.
     ƒ Get permission from the instructor or the department head.                         ƒ Students may choose not to release their directory information
     ƒ Submit the completed form to the Office of Admissions and the                        by completing a “Request to withhold or release directory
       Registrar during the regular registration period.                                    information” form, available at the Office of Admissions and the
     ƒ Pay tuition and fees by the last day of fee payment in the semes-                    Registrar.*
       ter you are enrolled. NOTE: Permission to enroll in a course
       must be obtained each time you register.

                        (Last)                                                        (First)                                          (Middle)

   SEMEStEr of ENrollMENt:  Fall                     Spring  Summer Year 20___
   UA ID # ____ ____ ____ ____ ____ ____ ____ ____ ____ DAtE of BIrtH (Month/Day/Year): ( __ __ / __ __ / __ __ __ __)
   (New students should provide their SSN)
   CUrrENt MAIlING ADDrESS:                                                                     Day Phone ______________________________________
   _________________________________________________________ Evening Phone ___________________________________
   _________________________________________________________ Email Address ___________________________________
   (City)                                  (State)                         (Zip)

residency1 Students seeking Alaskan residency or a waiver of non-resident surcharge must complete an “Application for Resident Tuition” or “Waiver of Non-
Resident Surcharge” and provide required documentation to the Office of Admissions before the published first day of instruction (UA Board of Regents Regulation
R05.10.05). See reverse side for information.

  DEMoGrAPHIC INforMAtIoN See reverse side for information and codes
 Sex:        Male  Female         Ethnicity2                          Vet/Military Status3
 For instructions on withholding directory information, please see reverse side.4
 US Citizen?     Yes  No           If no, Nation of birth:                        Nation of citizenship:                            Visa type:
  Name of high school you are attending: ___________________________ High School location: (city/state) ________________________________
           When will you graduate from high school? (MM/DD/Year) _______________________

office of Admissions and the registrar only:

  CoUrSE INforMAtIoN               (Complete all information requested below. Refer to the Class Schedule for course information)
                       Course                                                                           # of     “Yes” if    Instructor Signature (required after
    CrN        Dept.                 Section                        Course title
                       Number                                                                          Credits    Audit         last day of late registration) †

  I understand I or my parent are responsible for all applicable UAF academic regulations, tuition and fees whether or not I successfully complete
  the course or courses in which I am enrolling.

  Student’s Signature: X                                                                                          Date:

  Parent’s Signature: X                                                                                           Date:

   office of Admissions and the registrar only:
   Processed By:                                                                         Date:

   † E-mails directly from instructors or department heads are adequate.
First-time non-degree students or students returning to        The Office of Admissions and the Registrar is responsible
enrollment after more than a two-year absence are con-         for keeping student education records. The full copy
sidered non-residents until they submit an “Application        of the university’s policies regarding access to student
for Resident Tuition” with this registration form before       records under the Family Educational Rights and Privacy
the first published day of instruction and are approved        Act of 1974 (FERPA) are available at
(for the purposes of residency pursuant to UA Board of         ferpa/.
Regents Regulation R05.10.05) as a resident of Alaska.         Directory information
  For more specific criteria, please refer to the “UA
                                                               The university may release certain directory information
Application for Resident Tuition Assessment” at
                                                               to the public on a routine basis unless a student requests,                in writing, that the university not release it. Forms to
                                                               request that directory information not be released are
                                                               available in the Office of Admissions and the Registrar.
Code     Description                                             No directory information will be released until the last
AA       Alaska Aleut                                          day of late registration. Any request to withhold direc-
AE       Alaska Eskimo, other                                  tory information will continue until a student provides
AH       Alaska Indian, Haida                                  permission, in writing, for the university to release such.
AI       Alaska Indian, Other                                  After that, information will be released when appropriate.
AK       Alaska Indian, Tlingit                                The names of students who have requested their directory
AM       Alaska Indian, Tsimpshian                             information be withheld will not appear in the published
AN       Alaska Native, Other                                  university chancellor’s and dean’s lists.
AQ       Alaska Eskimo, Inupiaq                                  The following is considered directory information:
AS       Alaska Native, Southeast
AT       Alaska Indian, Athabascan                               1. Name
AY       Alaska Eskimo, Yup’ik                                   2. E-mail address
BL       Black, Non-Hispanic                                     3. Home city and state
HI       Hispanic                                                4. Weight and height of students on athletic teams
IN       American Indian (Not Alaska Native)
                                                                 5. Dates of attendance at UAF
OT       Other
PI       Asian, Pacific Islander                                 6. Program/major field(s) of study
WH       White                                                   7. Degrees and certificates received, including dates
XX       American Indian or Alaska Native                        8. Participation in officially recognized university
* Requested for compliance with Title IV of the Civil Rights         activities
Act of 1964                                                      9. Academic and co-curricular honors, awards and
                                                                     scholarships received, including dates
Code     Description                                           5 LATE PAYMENT/REINSTATEMENT FEES
Blank    Non-veteran                                           Students who miss the scheduled deadline with a balance
AA       Active Duty – Army
                                                               of $50 or more will be charged a late payment fee of $100.
AC       Active Duty – Coast Guard
                                                               An additional $100 late fee will be added to accounts
AF       Active Duty – Air Force
                                                               which are still not paid by the withdrawal deadline.
AN       Active Duty – Navy/Marines
                                                               Contact the Business Office (474-7384).
AO       Active Duty – Other
DC       Dependent Child
DS       Dependent Spouse
VR       Veteran – Discharged/Retired (Eligible)
WW       Widow/Widower

                                                               Office of Admissions and the Registrar, 102 Signers’ Hall,
                                                               PO Box 757480, Fairbanks, Alaska 99775
                                                               907-474-7500 (ph) • 907-474-7097 (fax) •