Form Owner:
prairiestate.edu
Step 1 of 2: Submit
PSC Registration Form
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Current Enrollment Objectives:
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Select an option:
Take one or several courses
Complete a certificate program
Obtain an Associates Degree
I am a guest student studying at PSC for the summer and transferring back to another college or university.
First Name
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Last Name
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Street Address
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City, State, Zip Code
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Student ID Number or Date of Birth
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Phone Number
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Email Address
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Term
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Course Name
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Course Section
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Course Name
Course Section
Course Name
Course Section
Course Name
Course Section
Course Name
Course Section
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
Take a Photo of Identification Card
Date:
Monday, 6 February 2023 (EST)
Name:
Type your name to sign this document:
Typing name is equivalent to a handwritten signature
If you do not have an active camera use the Upload Identification Card field below to upload your photo ID.
Upload Identification Card
Remove
Remove uploaded file
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:
Monday, 6 February 2023 (EST)
Name:
Type your name to sign this document:
Typing name is equivalent to a handwritten signature
For Internal Use Only:
Advisor Code:
*
indicates required fields