CLARION UNIVERSITY OF PA

Winter Intersession Quick Admit Form
 

The quick admit policy limits undergraduate students to a total of 12 credits. If a student wishes to continue coursework beyond 12 credit hours, he or she must seek admission to the University through the Admissions Office. Graduate students should contact the Division of Graduate Studies
at 814- 393-2337.

This is a non-degree program and as a result, students are not eligible to receive financial aid.  If you are interested in pursuing an associate's or bachelor's degree program at Clarion University, please complete the regular admissions process at www.clarion.edu/apply.  Students seeking a degree may receive financial aid.

Please complete the top portion of the form completely.  Use N/A for items that do not apply.   Items with an * are required entries.

Last Name*:       First Name*:      Middle Initial:   

Former Names: 

Street Address*:      City*:    

State*:              Zip*:           Email Address*:   

                                                                                             This email address will be used to confirm your registration.

Birthdate*:    (MM/DD/YYYY)       Sex*:     Select M F       Race:    Select White, Non-hispanic Asian or Pacific Islander Black, Non-Hispanic Hispanic American Indian/Alaska Native Prefer not to answer

Daytime Phone Number:          Home Phone Number*:     

PA Resident*:                    Select Yes No         If yes, name of county:   

Status*:           Freshman  Transfer  Transient/Guest            Campus Choice*:  Clarion  Venango  Online   Pittsburgh 

High School Attended*:       Dates Attended*:   (MM/YYYY - (MM/YYYY)

High School City and State*:   

GED received *:      Select Yes No               If GED earned, date GED was received:  (MM/DD/YYYY)

Have you attended Clarion University previously? *     Select No Yes

If your are a transfer or transient/guest student please list the following;

Full Name of College Name (no abbreviations please):       

Degree/QPA:      Current College Attendance Dates: 

REGISTRATION: The e-mail address specified on the form will be used to confirm your registration. All students must complete registration according to the procedures outlined for the session they are registering.  A maximum of one course may be taken in winter intersession.

Please include an ALTERNATE course in the event that your first choice is not available.

How did you hear about Winter Intersession? Please Select Clarion Website Email Direct Mail Telephone Friend, relative, or colleague Newspaper Search Engine (e.g. Google) Professional Organization Affiliation Other

By clicking the submit button, you are verifying that the information provided is accurate.