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Non-Degree Course Registration Form – Form N
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2019-07-31T16:11:29+00:00
Non-Degree Course Registration Form—Form N
This is a course selection form for the ESLU, ESLP, TOEFL and GED programs. This form will be used at a later date when the distant learning technology becomes available. FRENCH: Formulaire de selection de cours dans les programmes de ESLU, ESLP, TOEFL et GED. Ce formulaire sera utilisé à une date ultérieure quand la technologie des cours à distance sera disponible.
Personal Information
Student I.D. #
National I.D. #
Diploma or Degree Obtained (Please indicate)
Program of Study
English for University Preparation- ESLU
English for Personal & Professional Development-ESLP
GED /BAC Américain
TOEFL- Test of English as a Foreign Language
Other (specify)
Other
Name
First
Last
Date of Birth / Date de Naissance
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
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11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
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1971
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1939
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1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Place of Birth / Lieu de Naissance
(City/Village & Country)
Gender
Male
Female
Domicile
(City & District)
Email
*
Cell Phone
*
Home Phone (if any)
Emergency Contact
Emergency Contact Name
Emergency Contact Phone Number
Student Class Schedule
Please select courses from this session course list
Course Number/Section/Title
Meeting Days & Times
M
T
W
Th
F
S
Time Frame / Instructor
Course Cost
Course Number/Section/Title
Meeting Days & Times
M
T
W
Th
F
S
Time Frame / Instructor
Course Cost
Course Number/Section/Title
Meeting Days & Times
M
T
W
Th
F
S
Time Frame / Instructor
Course Cost
Course Number/Section/Title
Meeting Days & Times
M
T
W
Th
F
S
Time Frame / Instructor
Course Cost
Course Number/Section/Title
Meeting Days & Times
M
T
W
Th
F
S
Time Frame / Instructor
Course Cost
Course Number/Section/Title
Meeting Days & Times
M
T
W
Th
F
S
Time Frame / Instructor
Course Cost
Course Number/Section/Title
Meeting Days & Times
M
T
W
Th
F
S
Time Frame / Instructor
Course Cost
Total Cost to Pay
Submit
*VERY IMPORTANT:
It is the responsibility of the student that the completed form is received by the Registrar’s office for processing and that payment is made in a timely manner. Please refer to the Academic Calendar for payment Due Date and Refund deadlines.
*Students who wish withdraw from either a course or the College must receive official authorization from the Registrar’s Office. Failure to withdraw officially may result in the recording of an F grade for credit courses and Un-satisfactory notation for non-degree courses. A student who is asked to leave the College for misconduct or many unexcused absences will receive no refund of tuition or fees.
In consideration of this registration and enrollment at the American University of Cote d’Ivoire (AUCI), I, the undersigned student (or parent of a minor), do hereby agree to assume and PAY any and all tuition costs and charges including collection costs and attorney fees for unpaid tuition and other charges.
Signature
Print full name as an indication of acceptance.
Advisor Signature
Required only for a full time student.
Date
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