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.
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