Form Owner:
prairiestate.edu
Step 1 of 2: Submit
PSC Registration Form
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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
*
Select an option:
Spring 2021
Summer 2021
Fall 2021
Spring 2022
Course Name
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Course Section
*
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
Photo 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:
Wednesday, 27 October 2021 (EDT)
Name:
Type your name to sign this document:
Typing name is equivalent to a handwritten signature
For Internal Use Only:
Advisor Code:
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