B.A. Liberal Studies Napa Registration Form - Fall, 2014

OFFICE USE ONLY:
 Verified by:
Cash Receipt#:
Check #
 Payee Name
 VISA/MC authorization #
 Total Paid $:
 By  Date  

DO NOT EMAIL THIS FORM - IT WILL NOT BE ACCEPTED OR PROCESSED.

Fill in, print (using print button at the bottom of this form), then mail or fax to: SSU Extended Education, 1801 E. Cotati Ave., Rohnert Park, CA. 94928










Title of Course(s) you wish to enroll in:
  Course
 Dept & Course # (e.g. SPAN 500)
 Class #
Units
 Fee
Sexually Transmitted Diseases BIOL 311 4289
$1050
Chicano/Latino Youth CALS 403 4288 4 $1400
Portfolio Assessment SSCI 400 4287 3 $1050
Internship SSCI 499 4293 1 $  350
Internship SSCI 499 4294 2 $ 700

Internship

SSCI 499

4295

3

$1050


Total
$



If yes, you must complete and sign an Authorization to Apply Financial Aid to Other Charges form and return it to the Registrar in Extended Education, Stevenson 1012.

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Mail to: School of Extended Education, Sonoma State University, 1801 E. Cotati Ave., Rohnert Park, CA 94928-3609.
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