Nondegree Credit Registration

All fields marked with a * are required.

Workshop Information

Early Registration Code

Check Availability

Certain courses are only visible when submitting this code
Discount Code

Check Availability

Select Course

*	Course	Course Name	Credit Hours	Date/Times	Location	Cost
	EDU 599 A	SDCTM Summer Symposium	1.00	07/16/2024 to 08/01/2024		$70.00
	EDU 599 A	Book Study: The Will to Learn	1.00	09/02/2024 to 10/11/2024		$90.00

Personal Data

First Name

Last Name

Middle Name

Former last name(s)

Email (verify)

Phone Number

Cell Phone Number

Address

City

State

Zip

Birth Date

Gender *

Male Female

Social Security Number We cannot issue a 1098 tax form without this information.

Citizenship Status

US Citizen US Permanent Resident Other

Country of Citizenship

Country of Birth

Are you Hispanic or Latino?

Yes No

Regardless of your answer to the prior question, select one or more of the following ethnicities that best describe you
American Indian or Alaska Native Asian Black or African American Native Hawaiian or
other Pacific Islander White

Do you have previous Credit at DWU? *

Yes No

What Year?

Credit Card Information

Credit card number will be requested after submitting this form

Name/Address as it appears on your CC statement *

Same as above Different