UWSP MAIL REGISTRATION FORM

UWSP MAIL OR FAX REGISTRATION FORM
MAIL: WCEE Attn: Nicole Filizetti, 403 LRC, UWSP, Stevens Point WI 54481 FAX: 715-346-4698
Last Name
First Name
Middle
Maiden
UWSP ID# or Social Security Number (required)
Email Address (required)
Date of Birth (mo/day/yr) (required)
Home Phone
Home Address
Work Phone
City
High School Graduated From (required)
School Name/Employer
State
Zip
City/State
School/Employer Address
Year of Graduation
City
Grade Level(s)/Position
County
District
State
ZIP
Subject Area(s)
Application Status:
 High School Student (Youth Options Program) – 20

Undergrad Special (taking undergrad courses but not toward a degree at UW-SP, or a student with a degree taking undergrad courses for
teacher certification, additional majors or degrees, self improvement, etc.) – 9

Grad Special (taking graduate courses, but not seeking a master’s degree at UWSP) – 10
NOTE: There is no guarantee that courses taken as a Grad Special can later be used to fulfill master's degree requirements.
It is in your best interest to submit an application for Graduate Study if you might pursue a graduate degree in the future.

Grad Regular (applied and accepted to a master’s program at UWSP) – 11
Grad Program of Study: __________________________________________
Intended Graduate Degree  MA
 Male (M)
Sex
Advisor _______________________________
 MEPD  MMED  MS  MSE  MST  DOCTOR OF AUDIOLOGY
 Female (F)
 Citizen (C)
 Nonresident Alien (N)
 Permanent Immigrant (P)
Alien Registration No. ___________________
Veterans Benefits Status
 Not a Veteran (0)
 Receiving VA benefits (2)
 Veteran Not Receiving Benefits (9)
Citizenship
Racial/Ethnic Heritage
 African American/Black (B)
 American Indian or Alaska Native (N)
 Southeast Asia: Cambodian, Hmong, Laotian, Vietnamese (E)
 Other Asian/Pacific Islander (O)
 Hispanic/Latino (S)
 White/Non-Hispanic (W)
RESIDENCY:


 Yes
 Yes
Have you, your spouse or parent(s) recently moved to Wisconsin to Accept Permanent Employment?
Do you claim Legal Wisconsin Residence for tuition purposes?

Indicate the dates you have lived at your present address

List former addresses (street, city, state) within the last two years
________________________________________________________________________________
________________________________________________________________________________

Employment history and/or activities (other than school) for the last two years (include city/state)
________________________________________________________________________________
________________________________________________________________________________

Parent’s Name (City and State of residence within the last two years)
________________________________________________________________________________
________________________________________________________________________________
 No
 No
From (mo/yr)________ to (mo/yr)______
From (mo/yr)________ to (mo/yr)______
From (mo/yr)________ to (mo/yr)______
From (mo/yr)________ to (mo/yr)______
From (mo/yr)________ to (mo/yr)______
From (mo/yr)________ to (mo/yr)______
From (mo/yr)________ to (mo/yr)______
Please Note: It is your responsibility to register correctly, as a resident or nonresident, under the law.
Term
Prefix &
num
Section
Credits
Title
Location
Spring 2014
NRES 623
88
1
Human Influence on Wisconsin’s Forests
Online
Have you previously taken courses offered by UW Stevens Point, either on-campus or
off-campus?
Yes
No
Office Use Only
N
R
MAIL OR FAXTHIS REGISTRATION FORM TO THE ADDRESS SHOWN AT TOP. MUST INCLUDE CORRECT PAYMENT.
UNIVERSITY OF WISCONSIN-STEVENS
POINT
PARTIAL PAYMENT PLAN CREDIT
AGREEMENT
I have read and agree to comply with the
Partial Payment Plan Credit Agreement
I guarantee payments within the terms
specified.
All credit extended will be my obligation.
SIGNATURE
______________________________________
(Name of Student)
Student ID Number
__________________________________
(Social Security Number)
Date
______________________________________
ALL STUDENTS must sign this agreement.
Under the partial payment plan, charges will be
billed as follows:
First Statement - Information only. No
required payment due at this time. However,
finance charges will be assessed on any unpaid
balance as of the first day of each term.
Second Statement - Fifty percent (50%) of the
balance plus finance charge will be due.
Third Statement - One hundred percent (100%)
of any remaining balance plus finance charge
will be due.
FINANCE CHARGES will begin accruing the
first day of each term.
ANY HOLDER OF THIS CONSUMER CREDIT
CONTRACT IS SUBJECT TO ALL CLAIMS
AND DEFENSES WHICH THE DEBTOR
COULD ASSERT AGAINST THE SELLER OF
GOODS OR SERVICES OBTAINED
PURSUANT HERETO OR WITH THE
PROCEEDS THEREOF. RECOVERY
HEREUNDER BY THE DEBTOR SHALL NOT
EXCEED AMOUNTS PAID BY THE DEBTOR
HEREUNDER.
______________________________________
I UNDERSTAND I WILL BE RESPONSIBLE
FOR ALL REASONABLE COLLECTION COST,
INCLUDING ATTORNEY FEES AND OTHER
CHARGES NECESSARY FOR THE
COLLECTION OF ANY AMOUNT NOT PAID
WHEN DUE.
PARTIAL PAYMENT PLAN PLAN CREDIT AGREEMENT
Students choosing the partial payment plan
shall pay FINANCE CHARGES, which will
appear on the billing statement for each period
in which the entire balance is not paid in full by
the billing due date. The FINANCE CHARGE is
calculated on the Previous Balance (exclusive
of the previous FINANCE CHARGES) reduced
by Payments and applied Credits as they are
made during the billing period. The FINANCE
CHARGE will be calculated at the periodic rate
of .041095% per day or 1 ¼ % per month
(ANNUAL PERCENTAGE RATE OF 15%) on
that portion of the balance which is $500 or
less, and at the periodic rate of .032877% per
day or 1% per month (ANNUAL PERCENTAGE
RATE OF 12%) on that portion of the balance
which is in excess of $500.