Goldey-Beacom College
Student Schedule Worksheet

 
__ Returning Student __ Undergraduate __ Fall 20____ __ Spring 20____
__ Re-entering Student __ Graduate __ Winter 20____ __Summer 20____
__ New Student __ Non-degree  
Student ID# __________________________
Name_____________________________________ E-Mail ______________________________
Address___________________________________ Home# (____) ________________________
__________________________________________ Work# (____) _________________________
COURSE
NUMBER/SECTION		 CHECK IF REPEAT SESSION MON TUE WED THU FRI SAT # OF
CREDITS
PLEASE NOTE: Course selection cannot be reserved until past due balances are paid in full. Course schedules may be removed from the computer if payment is not received by the due date.  A Late Registration/Payment fee will be assessed if payment is not made on time.
Total number of Credits __________ X $______  Per Credit = $______________
Student Service Fee __________ X $___  Per Credit = $______________
Total Amount Due $______________
I have read and understand the College's guidelines and policies as stated in this bulletin.

_________________________________

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STUDENT'S SIGNATURE/DATE SUBMITTED ADVISOR'S SIGNATURE/DATE INPUT
BANK CARD PAYMENT AUTHORIZATION
I am authorizing Goldey-Beacom College to charge my bank card for $______________, the total amount due, and have filled in the information requested below. (Payment is charged when form is received.)
__Visa __M/C __Disc/Novus __ Amer Exp. Exp. Date Print Name:
Account Number: Signature:
For Office Use Only: Total Paid $______________ Initials:______________