Online Pre-Registration Form
For Internet, Televised, Hybrid, and Correspondence Courses

All requested information must be provided before enrollment can be completed.
For additional information contact Ms. Barbara Herford , Lifelong Learning, at  (417) 625-9652.


PERSONAL INFORMATION

Last Name:
First Name:
Initial:
E-mail Address:
 Student SID Number:
(SSN if not yet admitted)
Date of Birth:
 		Semester:
 Year:

Are you going to enroll in distance learning classes only?

If enrolling in both Summer and Fall, please submit one form for each semester.

Indicate which semester you wish to enroll in above i.e. Spring; Summer; or Fall.

MAILING ADDRESS

Street:
 City:
State:
 Zip:
Home Phone:
 Work Phone:

CLASS SCHEDULE

CRN
(Course Reference Number)

Course Number
(Subject and Number)

 Course Title

Contract of Enrollment:

I understand that by completing and submitting this form for either pre-enrollment or regular enrollment,
I am committed to timely payment of all fees associated with my enrollment, including finance charges and collection costs.

Actual enrollment in these courses will be dependent upon class availability and enrollment eligibility. Admissions procedures must have been initiated and the one-time, non-refundable application fee paid for first time MSSU students. You must be admitted to MSSU before we can process any enrollment requests. Transcript information for courses taken anywhere other than MSSU must be on file to allow enrollment in any courses with pre-requisites - please check the course description for this information prior to requesting enrollment.

Upon completion of enrollment by Lifelong Learning an e-mail will be sent to you with confirmation.

You are not registered for any classes until you receive confirmation!

TUITION AND FEE REFUND POLICY

Prior to end of first week of classes: 100%

Second thru fifth weeks: Student is responsible for 40% of tuition and fees. The 60% refund is not applicable for special course or record fees.

After fifth week: None - student is responsible for 100% of tuition and fees.

Money paid by financial aid sources will be fully reimbursed before monies are refunded to the student.

NOTE: The above refund policy does not apply to students with federal financial aid.



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