Jenzabar University

EARLY COLLEGE REGISTRATION FORM

• Graduating Class of 2020 can only use this form to register for Summer courses.

• Classes of 2021, 2022, 2023 can use this form to register for Summer or Fall courses

First Name:

Middle Initial:

Last Name:

Date of Birth: (MM/DD/YYYY)

Gender:

Street Address:

City:

State:

Zip Code:

Email:

Cell Phone:

Texting

Mobile Carrier:

What state do you attend high school in?

High School:

Year of Graduation:

State Identification Number:

^High School students attending a Maine public High school can get this 9-digit number from guidance/aspirations.

^ ALL home schooled students use 999999999.

^ Students from private high schools OR students earning their HiSET/GED/Adult Diploma, please leave blank.

Cost Factor

Candidacy Year

Stage

When would you like to take an early college course?

Hidden Term Code

Hidden Year Code

Course:

Dates

Location

Days of Week

Times

Amount

Courses

Division

Attribute

Code

If you are a senior, your early college registration form will automatically double as a FREE admissions application.

Choose a program of study: