Temple University Center City

Non-Matriculated Student Registration Form

The deadline to submit this form is the Friday before the start of the semester.

Use this form if you wish to register for credit courses but have not applied and been admitted to a degree program at Temple University. You may take credit courses for professional development, personal enrichment, or eventual application to a Temple degree program. Visiting students from other colleges or universities should also use this form.

Type in your information, submit it or print this page out and fax or mail it to the address below.

Fax to:
Advising Coordinator
Temple University Center City
1515 Market Street, Suite 215
Philadelphia, PA 19102
Fax: (215) 204-5813

Please fill out the following:

Semester: Fall Spring Summer I Summer II

I have previously attended Temple University.
Please provide yout TU ID:
I have never attended Temple University.
Please contact the Advising Coordinator (215-204-4358)

PART 1

1. Mr. Mrs. Ms.

2. Last Name First Name Middle Initial

3. Birth Date     Month Day Year

4. Address 1

   Address 2

   City State Zip

5. Day Phone

6. Evening Phone

6a. Cell Phone

7. Email Address

8. High School

9. Year Graduated

10. I intend to apply to a degree program at Temple
    Yes No

    10a. If yes, what program

11. I am taking course(s) for /
     Professional Development Personal Enrichment

12. I already have an undergraduate degree Yes No

    12a. If yes, name college or university

     12b.Year Graduated

PART 2

STATEMENT OF LEGAL RESIDENCE

Country of citizenship

Do you currently reside in Pennsylvania? Yes No

In what state do you claim permanent legal residence?
STATE

If you are under the age of 22 or are a dependent of your parent(s) or legal guardian(s), in what state do your parent(s) or legal guardian(s) currently reside in?
STATE

If you are a foreign national, what is your visa type and registration number?
Visa Type
Registration Number

Have you been a student at any time during the past 12 months? Yes No

If yes, Dates of Attendance

If yes, name of institution

If currently in Military Service, are you assigned to active duty at PA Military installation? Yes No

If you are a spouse or dependent of a military person assigned to active duty at a PA Military installation, please indicate relationship
Spouse Dependent

I am now and have been since

(Month)

(Year) ,

a legal resident of the state of

TEMPLE UNIVERSITY RESERVES THE RIGHT TO REQUEST DOCUMENTARY EVEIDENCE IN SUPPORT OF YOUR CLAIM OF LEGAL RESIDENCE.
Under of penalty of forfeiting my eligibility to attend Temple University, I certify that the entries made on this Statement of Legal Residence are correct and complete.

2. I certify the above information is accurate. Yes


   Signature_______________________________ Date ____/____/____
   (Not required for electronically submitted forms)

PART 3

Please select a course/or courses.

1. Course Selection

1a. Course Reference #
1b. Course # Section #
1c. Course Title
1d. Credit Hours

2. Course Selection

2a. Course Reference #
2b. Course # Section #
2c. Course Title
2d. Credit Hours

3. Alternate Course Selection

3a. Course Reference #
3b. Course # Section #
3c. Course Title
3d. Credit Hours

4. Alternate Course Selection

4a. Course Reference #
4b. Course # Section #
4c. Course Title
4d. Credit Hours

A tuition bill will follow. Please note the due date and room assignments indicated on your account statement/roster/bill.