Rdform - Spring 2004 Special Session Registration/Drop Form Submit to Admissions and Records by fax 408-924-2050 or walk-in Disabled Students who

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Social Security Number Voluntary $90 Health Card Fee Full Legal Name L A S T F I R S T M I D D L E Number and Street City State Zip Telephone: Daytime or Work ( ) nnn Evenings ( ) Date of Birth Male Female Highest class level achieved or degree obtained 0 No prior college 3 Junior (60-89 units) 6 Master’s Degree 1 Freshman (1-29 units) 4 Senior (90+ units) 7 Doctoral Degree 2 Sophomore (30-59 units) 5 Bachelor’s Degree Any other name you have used at SJSU TERM 2042 Amount Paid $ _____ SUBMIT WITH PAYMENT TO BURSAR’S OFFICE, STUDENT SERVICES CENTER $ $ $ $ $ $ $ to to to to to to to Submit to Admissions and Records by fax 408-924-2050, or walk-in. Disabled Students who need help with Phone Registration call 408-924-6000 or TDD 408-924-5990. SJSU ID Number Spring 2004 Special Session Registration/Drop Form Ethnic Origin 1. American Indian or Alaskan Native 2. Black Non-Hispanic 3. Chicano, Mexican-American 4. Other Hispanic
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This note was uploaded on 09/08/2010 for the course HS 295 at San Jose State University .

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