PSC Registration Form

I am a guest student studying at PSC for the summer and transferring back to another college or university.

First Name Last Name Street Address City, State, Zip Code Student ID Number or Date of Birth Phone Number Email Address

Term Course Name Course Section

Course Name Course Section

NOTE: You are responsible for dropping if you no longer decide to complete the course(s). Failure to drop will result in you receiving a failing grade, and you will be responsible for tuition and fees. Please view the academic calendar and refund table for applicable dates.

Identity Verification

Please upload a photo of one of the following:
-School ID
-Driver’s License
-State ID
-Passport
-Military ID

Photo Identification Card

If you do not have a photo ID card, email enrollment@prairiestate.edu.

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By signing, you agree to the above statement.

Date: Sunday, 16 May 2021 (EDT)

Name:

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