TRIO Course Registration Form

TRIO Course Registration Form
Completing this form DOES NOT register you for courses.

TRIO-SSS students are required to meet with Academic Success Coach, Annie van de Water, prior to registering for upcoming semesters.
- STEP 1 Schedule a registration appointment with Annie.
- STEP 2 Complete this form after discussing courses for the upcoming semester with Annie. This form is officially confirms that you have given consent to be registered for the courses discussed with Annie.
If you have questions about registering for courses, contact Success Coach Annie Van de Water at (989) 386-6622 x509, avandewater@midmich.edu, or Schedule an Online Appointment.
Student Name*

First NameMiddle NameLast Name
Mid Student ID Number*
You can find your Student ID Number on your Mid Michigan College Student ID Card or in your Self-Service Account.
Birth Date*

MonthDayYear
MidMich Email*
example@midmich.edu
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Has your information changed from your admission or previous registration?*

YesNo

What semester are you registering for?*
Type a semester (Fall, Winter, or Summer) and a year (2021, 2022, 2023, etc.)
What is your current Program of Study?*
Are you changing your Program of Study?*

YesNo
During which semester did you begin or will begin coursework for your new Program of Study?
Type a semester (Fall, Winter, or Summer) and a year (2021, 2022, 2023, etc.)
Use the fields below to register for a NEW course, ADD a course to your schedule for an upcoming semester, or DROP a course from your schedule for an upcoming semester.*
NOTE Registration is not complete until this form is submitted to the Enrallment/Registratian Office. If submitted, it obligates you, the student, ta pay a registration fee of $50 (if initially registered during the regular enrollment periad} ar $100 (if initially registered during the late enrollment period). This fee is refundable if all courses are dropped prior to the final tuition deadline for the term. This fee will be covered by financial aid if your aid has been approved and is in your account. You will be responsible for all tuition and fees for courses dropped after the first Friday of the semester.
Student Signature*

Clear
Date*

MonthDayYear
Significant effort has been made to ensure this content meets accessibility guidelines. If you encounter a barrier you can report the barrier at midmich.edu/reportaccessibilitybarrier or contact TRIO-SSS at (989) 317-9211 or trio@midmich.edu.

In its commitment to providing a safe environment, Mid Michigan College actively endeavors to broaden our diversity, promote equal opportunity, and prohibit any form of discrimination in its programs, activities, and conditions of admission or employment. Learn more about these efforts and policies by visiting midmich.edu/eeo, midmich.edu/titleix, midmich.edu/securityreport.
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