Unclassified Student Summer Application

First Name:

MI:

Last Name:

Email Address:

Phone:

Are you UR Faculty, Staff or a dependent?

Yes

No

Which?

If a dependent, what is the name of the UR employee and department:

Have you previously attended UR?

Yes

No

Date Last Attended (or closest estimate):

Last UR School Affiliation:

Have you previously enrolled under a different name?

Yes

No

Previous Name:

Primary Address:
(permanent)

Country

Street

City

Region

Postal Code

Personal Information

Date of Birth:

Gender:

Citizenship Status:

Are you Hispanic/Latino?

Yes

No

Education

High School Attended:

Graduation Date:
If you are still in High School, enter your projected graduation date

If you are a current high school student please have your counselor or a teacher submit a letter of recommendation to registrar@richmond.edu. The letter should address your ability to successfully complete college-level work.

Have you attended other colleges?

Yes

No

Number of other colleges attended:

Name of Institution (most recent):

Did you graduate?

Yes

No

Name of Institution:

Did you graduate?

Yes

No

Name of Institution:

Did you graduate?

Yes

No

UR Course(s) Registration

NOTE: Registration is based on a space available only. Approval to enroll does not guarantee registration in requested classes.

Number of courses for which you are applying:

Purpose for taking these courses:

For each course below, enter information found here.

Course 1

Subject:

Course Number:

CRN:

Section:

Summer Session:

Course 2

Subject:

Course Number:

CRN:

Section:

Summer Session:

Course 3

Subject:

Course Number:

CRN:

Section:

Summer Session:

Alternate(s) Registration

Would you like to register for alternate(s) if course(s) above is closed?

Yes

No

Number of Alternates:

Alternate 1

Subject:

Course Number:

CRN:

Section:

Summer Session:

Alternate 2

Subject:

Course Number:

CRN:

Section:

Summer Session:

Alternate 3

Subject:

Course Number:

CRN:

Section:

Summer Session:

Disciplinary Action

Have you ever been found responsible for a disciplinary violation at any educational institution you have attended from the 9th grade (or the international equivalent) forward, whether related to academic misconduct or behavioral misconduct, that resulted in a disciplinary action? These actions could include, but are not limited to: probation, suspension, removal, dismissal, or expulsion from the institution.

Yes

No

Have you ever been adjudicated guilty or convicted of a misdemeanor or felony?
Note that you are not required to answer “yes” to this question, or provide an explanation, if the criminal adjudication or conviction has been expunged, sealed, annulled, pardoned, destroyed, erased, impounded, or otherwise required by law or ordered by a court to be kept confidential.

Yes

No

If you answer “yes” to either or both questions, please provide approximate date(s) of each incident and briefly explain the circumstances and reflect on what you learned from the experience.

Signature

By selecting the "I Certify" and "I Accept" buttons, you are signing this Application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Application.

I certify that all information submitted in the admission process---including this application and any other supporting materials---is my own work, factually true, and honestly presented, and that these documents will become the property of the University of Richmond and will not be returned to me. I understand that I may be subject to a range of possible disciplinary actions, including admission revocation, expulsion, or revocation of course credit and grades should the information I have certified be false.

I Certify

I agree to notify the institutions to which I am applying immediately should there be any change to the information requested in this application, including disciplinary history.

I Accept

I agree to abide by the regulations approved by the faculty and published in the current catalog of the University of Richmond. I further agree to pay all tuition and fees associated with this course pursuant to the schedule of fees established by the Bursar.

I Accept

Electronic Signature:

Today's Date:

University of Richmond admissions offices do not discriminate on the basis of race, color, ethnicity, national origin, religion, creed, sex, age, marital status, parental status, physical disability, learning disability, political affiliation, veteran status, or sexual orientation.