Part-Time Non-Degree Student - Online Course Registration Form

Anyone 18 or older is welcome to enroll part-time (11 credits or less) in classes at LSSU. You do not need to be formally admitted.

You must be formally admitted if you are working toward earning a certificate or degree, or seeking financial aid of any kind (V.A., Michigan Native Tuition Waiver, Pell Grants, Guaranteed Student Loans, BIA, Basic Grants, etc.). Apply for Admissions at

(* = required)


All Non-U.S. Citizens must apply for admission into a degree program. Apply for Admissions at

Are you a U.S. Citizen? *
 Yes  No

Course Registration Form

Last Name *
First Name *
Date of Birth (used to verify our records) *
/ / (MM/DD/YYYY)
Email address *

Local Information

Street *
City *
State/Province *
Zip/Postal Code *
Home/Cell Phone *
( ) -
Work Phone
( ) -

Permanent Information

Check if Local and Permanent is the same
Street *
City *
State/Province *
Zip/Postal Code *
Home/Cell Phone *
( ) -
Work Phone
( ) -

Other Information

Gender * Male Female
Are you a high school graduate? * Yes No
High School Name: *
High School Location: *
Are you currently enrolled in High School? *
If yes, see the Registrar's Office for
additional information that must be
Yes No
Have you previously attended LSSU? * Yes No
If yes, indicate last term/semester and year attended.
Under what name were you last enrolled at LSSU?
Note: In order to change your name, you must supply a copy of your
Social Security Card to the Registrar's Office.
Have you attended other colleges/universities? * Yes No
If yes, name of school(s)
Dates attended:
Total approximate semester credits earned
to date from all colleges attended: *
0-25 (Fr.) 26-55 (So.) 56-87 (Jr.) 88+ (Sr.)
State or province you were born:
State in which you are registered to vote: *
How many years have you lived in Michigan?. *  
If less than 1 year, enter 0.

Ethnic/Race: Optional Information for Statistical Purposes

Indicate all races that apply among the following:   White
Black or African American
Canadian Aboriginal - Tribe
American Indian or Alaskan Native - Tribe
Native Hawaiian or Pacific Islander
Check your ethnicity: Hispanic or Latino
Not Hispanic or Latino
Are you a veteran of the armed forces? Yes No
  If yes, list number of years of active duty

Course Registration

All stated prerequisite or co-requisite requirements for any courses you wish to register for will need to be satisfied. If you have questions about specific course prerequisite requirements, please consult the academic catalog or the instructor of the course. You may reach the instructor by calling the academic department responsible for the course. For further information, see Lake Superior State University's Student Registration Guide "Prerequisites/Co-requisites" information.


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  Course No.


CRN(If known)

Course Title


                    Total Credits

Add Alternate Course or Section Requests


Terms of Registration

By submitting this registration form, I understand that I am responsible for all costs associated with the class or classes regardless of attendance and will receive a grade at the end of the semester.  If I decide to withdraw, it is my responsibility to formally drop my class or classes. I will follow the Add/Drop/Withdrawal Policy as outlined on Lake Superior State University's Course Registration Information webpage at  If I have questions or concerns regarding the above information or Lake Superior State University's Add/Drop Policy, I will contact the Registrar's Office at 906-635-2682.

* I agree I DO NOT agree

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