CCGPS Registration Form

To:(Academic Advisor):
Today's Date:		Month Day Year
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 Name	Location	Section#	Credit Hrs	Course Date



Session/Year	Course#	Course Name	Location	Section#	Credit Hrs	Course Date



Session/Year	Course#	Course Name	Location	Section#	Credit Hrs	Course Date



Session/Year	Course#	Course Name	Location	Section#	Credit Hrs	Course Date



Payment		Financial Aid Credit Card Check
Signature

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