Student Course Add Form
This form should be used when a student needs assistance with adding a course.
Student Name
*
First Name
Last Name
LoLA/Banner ID:
*
Student Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Birth Date
*
-
Month
-
Day
Year
Date
Semester
*
Program/Major
*
Course Information
*
Signature
*
Date
*
-
Month
-
Day
Year
Date
Student Comments
To be completed by the Registrar
Registrar Comments
Reviewed or Processed By:
*
First Name
Last Name
Date Processed:
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: