Florida Keys Registration Form

Reserve your spot for Florida Keys Trip!

Completing this form allows you to reserve your spot for the trip, make your $250 non-refundable deposit, and you will be automatically enrolled in the course when summer registration opens.
Student Name*

First NameMiddle NameLast Name
Mid Michigan College 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
Mid Mich Email*
example@midmich.edu
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Legal Gender*

FemaleMale
Gender Identity*

FemaleMaleNon-BinaryPrefer to Self-Describe
Has your information changed from your admission or previous registration?*

YesNo
Confirm your selection and complete payment via PayPal using the options below.*
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2026 Florida Keys Trip DepositThis deposit is non-refundable. The travel fee for this course is $1,600.00, and the $250.00 non-refundable deposit will be applied to the travel fee. The remaining travel fee of $1,350.00 will be billed with Summer 2026 tuition and fees in May 2026, and is due in full on May 4, 2026.
$250.00

Total

$0.00
Student Signature*

Clear
Date*

MonthDayYear
NOTE Registration is not complete until this form is submitted. If submitted, it obligates you, the student, to pay a registration fee of $50 (if initially registered during the regular enrollment period) or $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.
Pay with PayPal

Choose from one of the PayPal options to make your payment.
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Reserve your spot for Florida Keys Trip!