* Required Fields

University ID

Last Name*

First Name*

Middle or Maiden

Email Address*

Street Address*

City*

State* Zip Code*

Phone*

Date of Birth

Sex: M F

Marital Status: Single Married

Employer (if any)

Job Title

Business Phone

Cell Phone

Are you a U.S. citizen? yes No

Are you applying for veteran benefits? Yes No

With which University of Hartford college are you affiliated? Full and part-time matriculated (formally admitted) students should indicate the same college in which they were enrolled during their last semester of attendance. University of Hartford non-matriculated students and visitingstudents should indicate "Not Affiliated".

College Name Hartford Art School College of Arts and Sciences Barney School of Business Hillyer College The Hartt School College of Education, Nursing College of Engineering, Technology, & Architecture University Studies Not Affiliated

Registration Status: Undergraduate, first Graduate, new to the University Returning or continuing student(undergraduate or graduate Special non-credit student only

Student Level Undergraduate Graduate Other - taking non-credit courses only

Please indicate your major (matriculated students only)

First Course Selection

Repeat U of H course? No Yes

Course Reference Number (5 digits)

Course Code (example AC)

CourseNumber (example 260)

Days Class Meets Time Room Location

Please indicate desired status for the above class Letter Grade Pass/No Pass Audit

Instructor Name

Tuition

2nd Course Selection

Repeat U of H course? No Yes

Course Reference Number (5 digits)

Course Code (example AC)

CourseNumber (example 260)

Days Class Meets Time Room Location

Please indicate desired status for the above class Letter Grade Pass/No Pass Audit

Instructor Name

Tuition

3rd Course Selection

Repeat U of H course? No Yes

Course Reference Number (5 digits)

Course Code (example AC)

CourseNumber (example 260)

Days Class Meets Time Room Location

Please indicate desired status for the above class Letter Grade Pass/No Pass Audit

Instructor Name

Tuition

4th Course Selection

Repeat U of H course? No Yes

Course Reference Number (5 digits)

Course Code (example AC)

CourseNumber (example 260)

Days Class Meets Time Room Location

Please indicate desired status for the above class Letter Grade Pass/No Pass Audit

Instructor Name

Tuition

Please note whether there is a prerequisite for the course(s) you have elected. If in doubt, call (860)768-4594.

Withdrawal: Tuition credit for withdrawal is governed by University policy as published in the current edition of the University catalog. If payment is not made in accordance with University Policy, the student may be denied grades, transcripts, diplomas and the opportunity to register for subsequent semesters. A default charge equal to 1.5% of the unpaid balance may be assessed each month until the balance is paid in full. If in the judgment of the University of Hartford it becomes necessary to engage the services of a collection agency or attorney's to effect collection to settle any dispute in connection with the above items, the undersigned agrees to pay such collection agency or attorney's fees, reasonable expenses, and costs as are hereby incurred. The student understands and agrees to these terms by submitting this form. A $30.00 registration fee must be included in the total.

Matriculated Students can also pay online if they go to the self-service center.
Non-Matriculated Students please see payment policy