UNITE REGISTRATION SHEET
for Students New to UNITE Distributed Learning



PERSONAL INFORMATION

* Indicates this is a required item

Last Name * First Name *
Middle Name * Previous Name (if applicable)
LAST term attended:    Term Year
University of Minnesota ID Number ( seven digits, including leading zeros if applicable)
University of Minnesota x.500 Internet ID (if applicable)
Address *
City * State * Zip Code *
E-mail Address *
Birthdate (dd/mm/yyyy)
How did you hear about the UNITE program?

Please tell us more about how you learned about UNITE Distributed Learning (200 character limit):


REGISTRATION

If you are already enrolled in an on-campus section of a course and are using this form to CHANGE your registration to a UNITE section of that/those course(s), please tell us which course(s):

UNITE Course Enrollment
Select Term:

Dept. Course # Course Title Credits Grade Option

Grade Option: A-F - Standard Letter Grade, S-N - Satisfactory/Unsatisfactory, AUDIT - Visitor/No Credit

If you are registered for other UNITE course(s) in same semester, check here:

If you are registered or plan to register for on-campus course(s) for in same semester, check here:

What date/time is your assigned registration queue for same semester?


UNIVERSITY OF MINNESOTA INFORMATION

Select your enrollment status for this UNITE registration:

IF admited to University of Minnesota Graduate or Undergraduate Program, which program/major?

EXAM AND QUIZZES

For courses with exams and/or quizzes, UNITE-enrolled students are required to take the exam with a UNITE-approved proctor on the same day/same time as the on-campus section of the course (see Exam Infomation for UNITE-Enrolled Students Icon to indicate link opens in new window or tab.).

Only instructors may grant permission to time-shift an exam time or to take the exam with the on-campus section. UNITE can not approve any modifications to this policy.

* By checking this box, I understand and agree to abide by the UNITE Exam Policy.
(CHECK HERE)

TRAVEL DURING SEMESTER

Enrollment through UNITE is limited to students who are located in the United States during the semester for which they are registering. Short-term travel during the semester will require instructor and UNITE approval in the event of exams.

* By checking this box, I understand and agree to this Location & Travel Policy.
(CHECK HERE)

STUDENT INSURANCE COVERAGE

Beginning fall semester 2012, all students who are 1) admitted to a degree program, and 2) registered for six or more credits per semester (or three or more credits during summer term) that count towards the automatic assessment of the Student Services Fee, are required by the University of Minnesota to have health plan coverage. Students who meet both of these criteria are automatically enrolled in the University-sponsored Student Health Benefit Plan.

Note that UNITE courses are EXCLUDED from the automatic assessment of the Student Services Fee (see criterion number 2, above). However, if you combining UNITE courses with on-campus sections, you may automatically be enrolled into the Student Health Benefit Plan.

All Student Services Fee-paying University students will be automatically enrolled in the University-sponsored Student Health Benefit Plan and billed a non refundable semester coverage fee. To avoid being charged, students who have active health plan coverage that meets certain existing coverage requirements may request to waive the University-sponsored Student Health Benefit Plan (http://shb.umn.edu/students-and-scholars/shbp-waiver).

* By checking this box, I understand the University-sponsored Student Health Benefit Plan.
(CHECK HERE)

Press the button below to submit this course request. Upon successful submission, in the browser window that follows this window, you will see a message informing you that your request has been sent and you may close the browser window. If the message in the next indicates otherwise, please follow the instructions provided.



 

Questions?
Phone:  612-624-2332
Email: unite@umn.edu