Form Owner:
prairiestate.edu
Step 1 of 2: Submit
PSC Registration Form
Pop out
Full screen
Current Enrollment Objectives:
*
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
*
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
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
If you do not have an active camera use the
Upload Identification Card
field to upload your photo ID.
Take a Photo of Identification Card
Date:
Tuesday, 17 May 2022 (EDT)
Name:
Type your name to sign this document:
Typing name is equivalent to a handwritten signature
Upload Identification Card
Remove
Remove uploaded file
If you do not have a photo ID card, email enrollment@prairiestate.edu.
Pop out
Full screen
By signing, you agree to the above statement.
*
Date:
Tuesday, 17 May 2022 (EDT)
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