Student Registration for Dual Credit Get a jump start on your college career Gain confidence Explore majors and areas of interest Courses offered at $90 per credit Student First NameStudent Middle NameStudent Last NameStudent Mailing AddressStudent Mailing AddressCountryStreetCityRegionPostal CodeStudent PhoneStudent Email AddressHigh SchoolAntietam High SchoolBerks Catholic High SchoolDelone Catholic High SchoolGovernor Mifflin Senior High SchoolLancaster Catholic High SchoolNativity BVM High SchoolOley Valley High SchoolTrinity High SchoolYork Catholic High SchoolGraduation YearThe following information is required either by federal agencies or for identification purposes:Social Security NumberStudent BirthdateStudent BirthdateJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember123456789101112131415161718192021222324252627282930312026202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900GenderFemaleMaleCitizenshipAfghanistanAland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamas, TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius, and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos Islands (Keeling Islands)ColombiaComorosCongo (Democratic Republic of)Congo (Republic of)Cook IslandsCosta RicaCote D'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland Islands (Islas Malvinas)Faroe IslandsFederated States of MicronesiaFijiFinlandForeign/UnknownFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambia, TheGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNaoeroNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorwayOmanPakistanPalau, the Pacific Islands ofPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamWallis and Futuna IslandsWestern SaharaYemenZambiaZimbabweReligionAnglicanAssembly of GodBaptistBrethrenBuddhistCatholicChristianChurch of GodEastern OrthodoxEpiscopalianGreek OrthodoxHinduHolinessIslamJehovahs WitnessJewishLutheranMennoniteMoravianMormonNazareneNoneOtherPentacostalPresbyterianProtestantQuaker FriendsRussian OrthodoxSeventh Day AdventistSikhismUkranian OrthodoxUnitarianUnited Church of ChristUnited MethodistWesleyanEthnicityAmerican Indian or Alaska NativeAsianBlack or African AmericanHispanicMulti-RacialNative Hawaiian or Other PacificUnknownWhiteIndicate below the Alvernia University courses for which the student is registering this academic year.For Example: THE 105 02Course SelectionART 201ART 208BIO 102BIO 103BIO 107BIO 115BIO 116BIO 117BIO 203BUS 100CHE 104CHE 110COM 101COM 103FRE 201FRE 202HIS 110HIS 121HIS 190HIS 281MAT 131MAT 208MAT 230MUS 135PHY 110POS 111PSY 101SPA 201SPA 202SPA 203SPA 204THE 245THR 155Student SignatureIn place of your signature, please type your full legal name:(First Middle Last)Parent SignatureIn place of your signature, please type your full legal name:(First Middle Last)Submit