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> Letter from Dean > Degree Programs >Graduate Policies >Courses > Registration


Graduate Student Registration Form
Education Information
Have you ever taken a course at Clark University?
Yes
No
 
Personal Information
Last Name:
First Name:
Middle Name/Initial:
Gender:
Female
Male
Ethnicity (Optional):
African American
American Indian/Alaskan Native
Asian
Asian-Sub Continent
Caucasian
Hispanic
Hispanic/Mexican American
Hispanic/Puerto Rican
Multiple Ethnicity
Native Hawaiian/Pacific Islander
Citizenship:
 
Mailing Address/Contact Information
Address:
City:
State:
Zip Code:
Is this a new address?
Yes
No
Home Phone:
Work Phone:
Email Address:
Employer Information
Employer Name:
Address:
City:
State:
Zip Code:
 
Course Selections
Course No. Course Title Grade Opt. Tuition
Registration Fee
Materials/Lab Fee
Late Fee
Total Tuition and Fees
Grade Options: Letter Grade, Audit, or Pass/Fail
 
Payment Method
This COPACE/Clark University Course Registration requires credit card payment information at the time you submit this form. COPACE will contact you for payment information. You may be asked to sign your name in an COPACE office to validate credit card tuition charges. It is recommended that you contact the COPACE office to confirm receipt of this form the next business/school day: (508) 793-7217.
 
 

 
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