Siena Course Registration

* = required field

What Semester are you registering for: *

Spring 2024

Summer 2024

Fall 2024

Winter 2024-25

Personal Information

Name *

First

Last

Birthdate *

YYYY

Student ID Number (SID#)

Legal Sex - Common App defines legal sex as the current marker on your government identification documents. This includes things like your birth certificate, passport, state ID, or driver's license. *

Gender *

Male

Female

Nonbinary

Other

If Other, please state

Please enter your home address *

Street Address

Street Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Cell Phone Number *

###

####

Email Address *

Emergency Contact Name *

Emergency Contact Cell Phone Number *

###

####

_______________________________________________________________

Have you ever been convicted of a felony? *

Yes

Please explain your felony conviction.

Have you ever received disciplinary action from any school? *

Yes

Please explain the disciplinary action.

An affirmative response to the above questions will not automatically prevent enrollment, but you may be asked to provide additional information. This information will be reviewed to ensure safety. Any falsification or omission of data may result in a denial of enrollment and/or dismissal.

__________________________________________________________

Student Registration Information

I am *

New Student

Re-Entering

Non-Matriculated

Graduate

High School Scholar

Auditor

Veteran

CSEA

PEF/PSTD

Siena Relationship *

Siena Employee

Employee Child

Employee Spouse

None of the Above

Country of Citizenship *

If not a US Citizen, are you a permanent resident? *

Yes

Education History

Do you have a H.S. diploma or equivalent? *

Yes

Have you ever attended Siena College? *

Yes

If Yes, Start Date

YYYY

End Date

YYYY

Other Name Used

Have you ever applied for Admission to Siena College? *

Yes

If Yes, Date you applied

YYYY

College Information

List all colleges you have attended

College 1

Location College 1

Date of Attendance College 1

Year of Graduation College 1

College 2

Location College 2

Date of Attendance College 2

Year of Graduation College 2

College 3

Location College 3

Date of Attendance College 3

Year of Graduation College 3

Optional - This is used for statistical reports only

How would you describe yourself?

Hispanic or Latino

American Indian or Alaskan Native

Asian

Black or African American

Native Hawaiian or Other Pacific Isle

White

I wish to enroll in the following classes at Siena College for the term listed at the top of the form:

I also understand that if I enroll in more than 11 credits, Full-Time Tuition Rates will apply. See Siena College Catalog on-line at www.siena.edu/academics. I also acknowledge that it is my full responsibility to inform Siena College if I no longer wish to take these classes. Failure to notify Siena will result in me being responsible for paying all of, or part of the tuition fee for these classes, as set forth by Siena College’s Business Affairs Office as pertaining to policies and procedures.

Course 1

Course 1 Title *

CRN # *

Credits *

Course 2

Course 2 Title

CRN #

Credits

Course 3

Course 3 Title

CRN #

Credits

Certification & Signature

By submitting this form on-line, I certify that the information I have given is complete and true to the best of my knowledge and that I shall comply with all the rules and regulations of the College which may be in effect or which shall become effective while I am a student, including those outlined in Siena Life. I understand that I must comply with New York State immunization health law and that failure to comply with the law may result in disenrollment from the college without refund of tuition and fees. I understand that Siena College reserves the right to ask for further information regarding my current and former educational records and to revoke my registration for prior unsatisfactory academic performance or conduct determined to be unacceptable for continued registration at the College. I also understand that the College may exclude, at any time, students who do not meet minimum academic standards in their registered courses or who engage in conduct in violation of the Student Code of Conduct or other policies set forth in Siena Life. I agree that if I engage in any recreational or athletic activities, I assume the risk involved in any such activities, and I hereby agree that the College will have no liability therefore. I acknowledge that Siena College has the right to deny registration based on the information listed on the form.