Course Registration Form
**This form may only be used when unable to register in Self-Service**
Name
*
First Name
Last Name
Student ID
*
(W Number)
Student Email
*
example12345678@my.yosemite.edu
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Format: (000) 000-0000.
Semester
*
Please Select
Fall
Spring
Summer
Section Number
*
This is always a four digit number
Course Name & Number
*
Example: CENGL-1A
Do you have more courses to add?
*
Yes
No
Additional Course Name/Number & Section Number (i.e. CENGL-1A-3241)
Please specify why you need to submit this form:
i.e. you have a repeat petition on file
In order to verify your identity, we need a copy of your ID. Would you like to attach by:
*
Uploading photo of your ID (preferred)
Taking a photo of your ID (preferred)
Other
Please specify how you will submit your ID
*
This option should only be used if the other two are not a viable option for you
Take Photo of ID
*
File Upload of ID
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Permission to Register
*
By checking this box, I give Columbia College permission to register me into the course(s) listed on this form.
Submit
Should be Empty: