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CCGPS Registration Form

To:(Academic Advisor):
Today's Date
Name
Student ID
Address

Check If Address Has Changed
Preferred Phone Number
Eastern Email
Major
Cohort Number
Is This Your First Course at Eastern University CCGPS? Yes No
Session/Year Course # Course NameLocation Section #Credit Hrs Course Date
Session/Year Course # Course NameLocation Section #Credit Hrs Course Date
Session/Year Course #Course NameLocationSection #Credit HrsCourse Date
Session/Year Course #Course NameLocationSection #Credit HrsCourse Date

Payment: Financial Aid  Credit Card   Check   Signature Date To prevent automated posts, please enter the text shown on the image as the verification code below.
Verification Code:


     

NOTE: Submission of this registration form obligates you to pay tuition and fees for all courses for which you are registered at the beginning of the academic session. Notification of registration change or cancellation must be submitted in writing to the Registrar. Per the "Electronic Signature in Global and National Commerce Act of January 2000," Eastern University accepts the above electronic signature as valid and legal.