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Note: If the term start date applicable to your class start date has already passed, please contact 734.487.0407..

Were you ever issued an EMU student number? Yes No

If yes, please provide your student ID Number: E Birthdate (mm/dd/yy)

First Name Last Name Middle initial

Former Name

Address City State/Province/Territory  

Zip Country:

Email Daytime Phone Evening Phone

Citizenship: United States Other (please specify) Country of Birth:

I am a permanent U.S. resident. Date resident status issued (mm/dd/yy):

I currently have a visa. My I-94 number is

I will apply for a visa.

State of legal residence How long have you lived there? years, months

Do you hold a bachelor's degree? Yes No

Was your cumulative GPA 2.5 or higher? Yes No

Eastern Michigan University's application and registration form includes the following questions regarding convictions and/or disciplinary history, and the information provided by the student may be considered when making the decision as to whether to admit and/or enroll the student to the University.

Have you ever been convicted of a criminal offense other than a minor traffic violation, found to be delinquent by a juvenile court, or are there any such charges pending against you at this time? Yes No

Have you ever been expelled, suspended, placed on probation or been subject to any other disciplinary action at any secondary school or college you have attended? Yes No

**If you answer yes to either of the above questions regarding criminal or disciplinary history, you must submit a full written explanation via email to: Please include your name and student number (if you have one) in that email.**

Optional Information:

Are you a U.S. veteran? Yes No

Gender Female Male

Are you Hispanic or Latino?

No, not Hispanic or Latino Yes, Hispanic or Latino: a person of Cuban, Mexican, Chicano, Puerto Rican, South or Central American, or other Spanish culture of origin, regardless of race.

What is your race? You may select one or more races.

White: a person having origins in any of the original peoples of Europe, the Middle East or North Africa

Black or African American: a person having origins in any of the black racial groups of Africa

American Indian or Alaska Native: a person having origins in any of the original people of North America (including Central America) and who maintains tribal affiliation or community attachment.

Asian: a person having origins in any of the original people of the Far East, Southeast Asia or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand and Vietnam.

Native Hawiian or Pacific Islander: a person having origins in any of hte original peoples of Hawaii, Guam, Samoa, or other Pacific Islands

Please indicate the courses in which you wish to enroll by specifiying their term and CRN number. Click here to find courses and copy their CRNs into the CRN fields. Link opens new window.

Term Course Prefix/Number (EX: MATH 100) CRN

Fall Winter Summer

Fall Winter Summer

Fall Winter Summer

Fall Winter Summer

I understand the registration and re-enrollment requirements:

This form registers you for the courses listed above. Registration for Extended Programs courses does not grant you admission to Eastern Michigan University. Credit earned as an Extended Programs student may not necessarily apply to a degree or certificate program. If you decide to pursue a degree or certificate, contact the Office of Admissions. Student must allow four to six weeks for complete application for admission or re-enrollment to be processed. If you previously attended EMU, but have not attended within the last eight semesters, you must re-enroll. Graduate students see the Office of Admissions in 400 Pierce Hall. Undergraduate students see the Office of Records and Registration in 303 Pierce Hall.

I understand that payment of tuition and fees is not required at the time of registration:

Electronic bills are normally emailed to your my.emich account the first weekend of each month and are due approximately three weeks later. All tuition and fees are subject to change, without prior notice and at any time, by action of the Eastern Michigan University Board of Regents. Such changes may be retroactive to the date of original registration.

I understand the University's Drop/Withdrawal Policy:

Dropping/Withdrawing from courses can be completed in one of two ways. Students who initially register through the Web-based system can also use it to drop a course during the dates specified by the Office of Records and Registration only (schedule adjustment fees may apply). Students who are not eligible to use the Web-based system or those wishing to avoid fees (the registration fee is non-refundable), should submit their drop/withdrawal in writing no later than seven business days (no later than four business days for spring/summer) past the first day of the term for 100-percent tutition refund. After that time period, drop/withdrawal must be completed in writing; however, no tuition will be refunded for individual withdrawals (total withdrawal from from the entire semester may be eligible for a partial refund). Courses of two weeks or fewer require written drop notification by the end of the first day of class to receive 100-percent tuition refund. Refer to the EMU class schedule for further details.

By checking this box, I acknowledge that I have read and understand the information on this form, and that I have read and understand the cancellation policies, and that the information I have supplied here is true to the best of my knowledge and belief. I realize that falisfication on this form may result in dismissal or disenrollment with no refund.