University of Dubuque
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Summer School

First Name

Middle
Last Name

Student ID-(UD students only)
Social Security Number

Birthdate (mm/dd/yyyy)

Email Address

Permanent Address
Street

City

State

Zip

Summer Address
Street

City

State

Zip

Telephone Numbers
Day

Evening
Cell


I wish to register for the following courses:
Select the Course Numbers Below that you want to register for.
Please note theSession Numberat the left of the course description.
You may select multiple courses by holding down the CRTL key (PC) or "Apple" key (MAC) as you make your selections.
Summer 2012 May 21 - August 10
Session--
Course Title--
Credits--
Instructor--
Days--
Time

Please list current college enrolled in:

Check here for verification*
Date*

Students Please Note:By checking the verification check box above, you agree to the regulations stated in the Summer School Policies, including the Add/Drop/Withdrawal deadlines.