Complete the following registration form to request enrollment as a non-degree seeking, non-matriculated student at the University of Rochester.

General Information

Fields marked with a * are required fields

* Registration Term:

University ID: (if applicable)

SSN: (optional)

UR Affiliation(s):

Faculty/Staff
Non-Matriculated Student
Alumni
Other:

* First Name:

Middle Name:

* Last Name:

Suffix: (Jr,III, etc.)

Previous Name(s):

Preferred Pro-noun:

Preferred Name:

* Street Address:

* City:

* State/Province/Territory(type N/A if none):

* Postal Code:

* Country:

* Birthdate: (Month)

* (Day)

* (Year)

* Sex:

You are under the age of 18, a parent must sign this form.

* Telephone:

* Email:

In case of emergency, contact:

* Name:

* Phone:

* Relationship:

Educational Information

* Are you currently enrolled in a degree or certificate program at UR? Yes No

If no, are you interested in pursuing a certificate or degree?

Yes No

* Have you applied to, or, are you applying to a University of Rochester degree program? Yes No

* Have you previously attended the University of Rochester? Yes No

* Do you hold a Bachelor's Degree or higher? Yes No

List all degrees earned:

Citizenship Information

IF YOU ARE NOT A U.S. CITIZEN:

Country of Citizenship:

Type of Visa:

Home Country Permanent Address:

Are you a permanent resident of the United States?

IF YOU ARE A U.S. CITIZEN:

Current State of legal residence:

If New York State, what county? (e.g., Monroe)

U.S. CITIZEN AND NON U.S. CITIZEN:

Are you Hispanic/Latino?

Regardless of your answer to the previous question, select one or more races you identify with:

American Indian or Alaska Native
Black or African American
White
Asian
Native Hawaiian or Other Pacific Islander

* Course Information

Indicate each course you are requesting to take at the University for the semester.

If instructor permission is required, please be sure to upload it below. If auditing the class, please complete the Audit Form from the Office of the University Registrar website, collect needed signature, and upload it below.

Course	Course Number	Course Section	Audit? (Y or N)	Course Title
Example: BIOL	106	1	N	The Making of Modern Africa

Upload 1st Course Permission Document:

Upload 2nd Course Permission Document:

Upload 3rd Course Permission Document:

Tuition and Fees Information

For course rate information, please visit the Office of the Bursar

Financial Certification

Read the below student finanacial responsibility statement. By submitting this form you agree to the below statement.

Student Financial Responsibility

Payment Of Fees/Promise To Pay: I understand and agree that by registering as a student at UNIVERSITY OF ROCHESTER and/or receiving any services from UNIVERSITY OF ROCHESTER I accept full responsibility to pay all tuition, fees, and other associated charges assessed as a result of my registration and/or receipt of services. I understand this agreement will remain in effect during the time I attend the University. I understand and agree that if I drop or withdraw from some or all of the classes for which I register, I will be responsible for paying all or a portion of tuition and fees in accordance with the published tuition refund schedule for UNIVERSITY OF ROCHESTER available in effect, at http://www.rochester.edu/adminfinance/bursar/refund-schedules.html. I further understand that my failure to attend class or receive a bill does not absolve me of my financial responsibility as described above.

Emergency or Temporary Closings and Other Changes in Class Schedules and University Operations

The University plans to commence and conclude classes on the dates indicated in the academic calendars. But unforeseen circumstances or events may occur that require the University to temporarily close or otherwise make adjustments to its student life, residential housing, class schedules and format, method and location of instruction, educational activities, and operations because of reasons beyond the University's control. For example, such circumstances or events may include but are not limited to inclement weather, the onset of public health crises, being subject to government order(s), significant safety or security concerns, faculty illness, malfunction of University equipment (including computers), and unavailability of particular University facilities occasioned by damage to the premises, repairs or other causes. If any of these or other unforeseen circumstances or events outside of the University's control occur, the University will respond as necessary and appropriate. And the University shall not be responsible for the refund of any tuition or fees in the event of any such occurrences.

Delinquent Account/Collection

Financial Hold: I understand and agree that if I fail to pay my student account bill or any monies due and owing UNIVERSITY OF ROCHESTER by the scheduled due date, the UNIVERSITY OF ROCHESTER will place a financial hold on my student account, preventing me from course registration-related activities including registering for future classes.

Late Fee: I understand and agree that if I fail to pay my student account bill or any monies owed to the University of Rochester by the scheduled due date, the University of Rochester will assess late fees at the rate of 1% per month on the past due portion of my student account until my past due account is paid in full.

Returned Payment Fee: If a payment made to my student account is returned by the bank for any reason, I agree to repay the original amount of the payment plus a returned payment fee of up to $20. I understand that multiple returned payments and/or failure to comply with the terms of any payment plan or agreement I sign with University of Rochester may result in cancellation of my classes and/or suspension of my eligibility to register for future classes at University of Rochester.

Collection Agency Fees: I understand and agree that should my student account not be kept current in accordance with this Agreement, any past due amount will be considered an unpaid educational loan/benefit. I acknowledge the University's right to begin collection action should my student account remain unpaid at the time I leave the University. I understand that I am obligated to reimburse the University the fees of any collection agency, which may be based on a percentage at a maximum of 33 1/3 percent of the debt, as well as all costs and expenses, including reasonable attorney's fees, incurred in such collection efforts.
Credit Bureau Reporting (Fair Credit Reporting Act) – The University reserves the right to report both positive and negative payment histories to credit-reporting agencies. I authorize the University, and their respective agents and contractors, to obtain a credit report on me at any time in the future to review my account.

Communication

Contact: I authorize the UNIVERSITY OF ROCHESTER and its agents and contractors to contact me using my current directory or future contact information, including any cellular phone number(s), email address(es), or wireless device(s), regarding my student account(s) and/or my student loan(s). I authorize the UNIVERSITY OF ROCHESTER and its agents and contractors to use automated telephone dialing equipment, artificial or pre-recorded voice or text messages, and personal calls and emails, in their efforts to contact me. Furthermore, I understand that I may withdraw my consent to call my cellular phone by submitting my request in writing to the UNIVERSITY OF ROCHESTER Bursar's Office and in writing to the applicable contractor or agent contacting me on behalf of the UNIVERSITY OF ROCHESTER.

Updating Contact Information: I understand and agree that I am responsible for keeping my UNIVERSITY OF ROCHESTER records up to date with my current physical address(es), email address(es), and phone number(s). Upon leaving the UNIVERSITY OF ROCHESTER for any reason, it is my responsibility to provide the UNIVERSITY OF ROCHESTER Bursar's Office with updated contact information for purposes of continued communication regarding any amounts that remain due and owing to the UNIVERSITY OF ROCHESTER and for the purpose of IRS 1098-T reporting.

Method Of Billing

I understand that the UNIVERSITY OF ROCHESTER uses electronic billing (e-bill) as its official billing method, and therefore I am responsible for viewing and paying my student account e-bill by the scheduled due date. I further understand that failure to review my e-bill does not constitute a valid reason for not paying my bill on time. E-bill information is accessible via UR Student. Information about UR Student is available at https://tech.rochester.edu/services/urstudent/

Billing Errors

I understand that administrative, clerical, and/or technical billing errors do not absolve me of my financial responsibility to pay the correct amount of tuition, fees and other associated financial obligations assessed as a result of my registration at the University of Rochester. Student Age I understand and agree that if I am younger than the applicable age of majority when I execute this agreement that the educational services provided by the UNIVERSITY OF ROCHESTER are a necessity, and I am contractually obligated pursuant to the “doctrine of necessaries.”

Governing Law

The provisions of this agreement are governed by the laws of the State of New York. I acknowledge that I have read and understand the terms appearing in the agreement.

* Student Signature:

* Date:

Students under the age of 18 must have their parent/guardian sign the following:

, the parent/guardian of

agree to be responsible for payment

pursuant to the terms of this payment agreement.

*Parent Signature:

*Date:

A copy of this form will be sent to the Registrar's Office. All requests take 3-5 business days to process.