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mji.edu  Academic Departments  High School  DE Registration
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COURSE REGISTRATION FORM

PERSONAL INFORMATION

First Name

Last Name
Middle Initial
Social Security Number
Gender
Date of Birth
Student Home Phone
Student Cell Phone
Student Email Address
Parent Home Phone
Parent Cell Phone
Parent Email Address
High School Currently Attending

ACADEMIC INFORMATION

Semester

COURSE SELECTION

EDU 121 Exploring Exceptional Children

EDU 131 Introduction to Early Childhood Education

EDU 122 Introduction to Speech and Language Pathology

EPH 160 Ethics and Society

HIS 140 Encountering Jewish Civilizations

HIS 261 Exploring the Holocaust I

HUM 120 Elementary Modern Hebrew II

HUM 242 Intermediate Modern Hebrew II

HUM 260 Advanced Modern Hebrew II

HUM 300 Seminar in Advanced Hebrew Language

JST 443 The History and Philosophy of Chassidut - III Modern Era

JST 171 Introduction to Jewish Philosophy

* Please note that in order for a course to run, the minimum number of required students must be enrolled.

By registering for a class as indicated, I agree to meet all attendance, conduct and classroom participation requirements. As a dual enrolled student, it is also understood that MJI may share information about my progress and performance with my high school and that MJI will contact my high school counselor if I exhibit disruptive behavior, repeated un-preparedness, a lack of satisfactory academic progress or excessive tardiness/absences.

The student or his/her parent/guardian is responsible for tuition and expenses and for applying for scholarships that may be available. If enrolling under the Postsecondary Enrollment Options Act, the student or his/her parent/guardian is responsible for tuition and expenses that the high school district has not agreed to cover.

I understand that by registering for courses I incur tuition charges on my account. I have read the appropriate sections of the MJI Academic Catalog and I understand MJI policies regarding maintaining satisfactory academic progress, late registration charges and adding, dropping or withdrawing from classes. I am also aware that my registration is not considered complete if there is any outstanding past-due balance on my account or until a payment agreement is accepted for the current semester.

Student Name

In lieu of signature, the final 4 digits of student SSN

Parent or Guardian signature is also required if student is under age 18

In lieu of signature, the final 4 digits of parent/guardian SSN

Thank you for Registering for our class(es). When you press the “submit” button, we will receive your registration form electronically. Please note: Two more forms need to get filled out to apply and register successfully:

  1. The Application Form - www.mji.edu/highschool/application this form needs to be submitted only once.
  2. Authorization A or B Form gets filled out by your high school counselor.

The Authorization A Form www.mji.edu/highschool/AuthorizationA is used when the student is taking course(s) as part of their high school requirement.

The Authorization B Form www.mji.edu/highschool/AuthorizationB is used when the student is taking course(s) in addition to their high school requirement.

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