Registration Form

Although the registration period may have ended, registrations can still be accepted for courses that are open and have not begun. Please contact the Options Office at 773.995.4466 to determine if the course you are interested in is still open. Thank you. We look forward to seeing you in class!

Directions for filling out the registration form:

  1. Print a blank copy of the form,.
  2. Fill in the blanks in ink, and
  3. Mail with payment to the Options address provided on this page.

OR

  1. Type in your response directly using your computer,
  2. Print the form, and
  3. Mail with payment to the Options address provided.

Note: This registration form is for Community Education/Options only.

Options Registration Form

Course #/Section Course Title Day

Time

Fee

 

       

 

 

 

   
   

 

 

TOTAL

 

                                           

Student Name:____________________________ Are you currently attending CSU? _______

Address:________________________________________________________Apt:_________

City:______________________________________________ State_______Zip:___________

Has your address changed?______ Previous Address:_________________________________

If minor, parent’s name:______________________ Is this your first Options class? _________

Day phone:_____________________________Evening phone:_________________________

 

If I decide to withdraw from the above class(es), I must notify you before the first class meeting. I understand that I am voluntarily engaging in activities offered under the Options Program and in so doing assume all risk of injury, illness, damage, or loss that may be associated with such activity.

Signature:_________________________________Date:_________________________

 

You may mail in your registration, fax it to us at 773.995.4429 or register in our office, Jacoby Dickens Center, Room 201 on the Chicago State University Campus. We accept Master Card, Visa, and Discover