Form Owner:
prairiestate.edu
Step 1 of 2: Submit
Advisor Registration Form
First Name
*
Last Name
*
Street Address
*
City, State, Zip Code
*
Student ID Number or Date of Birth
*
Phone Number
*
Email Address
*
Term Semester
*
Fall
Spring
Summer
Term Year
*
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
The advisor has verified the individual requesting to register is the student.
The advisor has read the following statements to the student:
• You are responsible for the tuition and fees associated with your registration.
• You must drop a course by the deadline if you no longer plan to complete the course.
• Failure to drop a course by the deadline will result in a failing grade and you being financially responsible for the tuition and fees.
• Refer to the
academic calendar
and
tuition refund table
for applicable deadline dates.
For Internal Use Only:
Advisor Code:
*
indicates required fields