Visiting Student Registration Form

Please complete form electronically and print. Submit form along with the Statistical Record and academic transcripts (official or unofficial) via fax or mail to:


Main Campus Office of Continuing Education
First Floor, Suite 101
1810 Liacouras Walk
Philadelphia, PA 19122
(215) 204-2500
(215) 204-2516 (FAX)

Name and Address Information

First Name: Middle Initial: Last Name:

Last 4 digits of SSN:

Day Phone: Evening Phone:

Address 1:
Address 2:
Address 3:

City: State:
Zip Code: Country:

E-mail address:

Course Selection

Please check for course prerequisites in the course description section of the graduate or undergraduate bulletin.

On-Line Course Schedule
Undergraduate Bulletin
Graduate Bulletin

Course Reference
Number		 Course
Session		 Department
Name		 Course
Number		 Section
Number		 Course
Title		 Credit
Hours		 Undergraduate
or
Graduate
1.
2.
3.
Please indicate if any of the courses selected above are Online Learning Courses, which are courses solely taken via the Internet.
Yes  No    If yes please list course(s) reference number.    ____________________

Registration Policies and Procedures

Please refer to Temple's Office of Academic Records for registration policies and procedures, including information regarding tuition & fees, schedule revisions, and other pertinent dates and deadlines.

Registration Authorization

This section must be completed by an authorized representative of the student's home institution, certifying that this student is permitted to take the course(s) listed above at Temple University. The student is aware of any applicable academic criteria, policies and/or procedure regarding the transfer of credits from Temple to the home institution.

Home Institution:___________________________________________________________

Name of Institutional Representative:__________________________________________

Signature of Institutional Representative:_____________________________________

Title:__________________________________________

Telephone/Fax Number:__________________________

Date:______________________

Please note: The Visiting Student Registration form, Statistical Record, and academic transcripts (official or unofficial) must be submitted in order to begin processing registration requests. All application materials must be received by the first day of the semester in which you are intending to take coursework. Information may be submitted in person, by mail or by fax to 215-204-2516.