OFFICE USE:   PIP –Prerequisite in progress, PNM- Prerequisite not met, CTC-course time conflict, CLS- Closed class, CRN- Wrong CRN, WTL- Waitlisted
                                         Advisor’s Signature                                                                           Student signature
1.
The registration form must be COMPLETED PRIOR to entering the registration area, as it will be used to key your
course request(s).
2.
Please make sure the COURSE REFERENCE NUMBER (CRN #) has been entered correctly. Schedules must have a
CRN# to be entered.
3.
Changes in biographical data (name, address, phone #) must be reported to the Office of Enrollment Management.
         Fall          Spring         Summer          Yr. _________        Date:_______________
   Course Level:      Undergraduate         Graduate   Daytime Phone #:_____________
    SS#:___________________             Name:_______________________________________
                                                                               Last                                First                                     M.I.
                                                               Address_____________________________________
                                                                                  Mailing                 City             St                   Zip
       SAMPLE SCHEDULE
                                         CRN#        SUBJ             CRSE#            SEC       CRED        DAY             TIME           AUDIT
                CRN#          SUBJ            CRSE#             SEC            CRED             DAY             TIME           AUDIT
Alternate Course Selection (s)
Total Credits:                                   [                  ]
     12345         MAT
        231
   A
     4
    MTWF       1:00-1:50
Office Use
 Email:
GENERAL INSTRUCTIONS/INFORMATION
REGISTRATION  FORM
 
University of the Virgin Islands
Registration Form
Social Security #
                  Fall
        Spring
           Summer   20
Campus:           STT                 STX      Level:
      Undergraduate                              Graduate
Name:
Last
First
  Middle
                   Former
Permanent Address:
              Local Mailing Address:
Zip
       Zip
Phone: Home (          )
     Work:(          )                                      Ext
Sex:   Male         Female
                   U.S. Citizen           Yes               No
                   Permanent Resident
 Date of Birth:
                                   Alien Registration #
  DD         MM          YY
                   Non Resident Alien:  Type of VISA
 F          J           H
In compliance with federal reporting requirements, UVI must seek to identify the ethnic background of
students enrolled. You are encouraged to supply this information.
1. Black/Non-Hispanic
3. Asian/Pacific Islander
 5. White/Non-Hispanic
2. American Indian/Alaskan
4. Hispanic
 6. Other
In what state/country is your permanent residence?
Have you lived in the Virgin Islands for the past twelve (12) months?            Yes           No
Last attended UVI
I certify that the information given on this form is complete and correct. I acknowledge that deliberate
omissions or falsifications may subject me to immediate dismissal from the University.
Under the provisions of the Family Educational Rights and Privacy Act of 1974, as Amended, you have the
right to withhold the disclosure of any directory information. If you would like that your name not be listed
in a directory please indicate.            Yes           No
                      Student’s Signature
              Date