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Enrollment Information Form for Contract Course Students

The information provided will determine your next steps for enrollment at The Ohio State University. Once submitted, we will contact you via email within 3-5 business days to provide you with required next steps.

If you have any questions, please contact Extended Education (part of Professional and Continuing Education/PCE) at OTDI-ContractReg@osu.edu (email preferred) or 614-292-8860.

1. Please provide the following information:

First name

Last name

Email address

Phone number
(include area code)

Date of birth
(mm/dd/yyyy)

2. Have you used any other name (such as a maiden name) that is different than the one you identified above?

Yes

No

2a. If you have used another name(s), please specify below.

3. Have you previously been enrolled at The Ohio State University?

Yes

No

3a. What is the most recent academic term that you attended The Ohio State University?

Autumn

Winter

Spring

Summer

3b. What is your most recent year of enrollment at The Ohio State University?

3c. The following information is not required, but may help us with locating your Ohio State records.

OSU Name.#

OSU ID (8 or 9 digit number)

SSN (last 4 digits)

Note: Please contact the Registrar's Office at 614-292-0300 or ssc@osu.edu to update your record if you have made any changes regarding your citizenship and/or visa since you applied to The Ohio State University.

4. Are you a United States Citizen, Permanent Resident, Refugee, or Asylee?

Yes

No

4a. What is your Country of Citizenship?

5. What is your permanent address?

Address

City

State/Country

Postal code

6. Is the address you identified above different from your home/current address?

Yes

No

6a. What is your home/current address?

Address

City

State/Country

Postal code

9. Identify the academic term for which you are applying.

Autumn

Spring

Summer

10. Specify the year for which you are applying.

11. Specify the course or courses that you are requesting:

11. Specify the **course or courses** that you are requesting:
	Department Name	Course #	Class #
Course 1	Course 1	Course 4	Course 3
Course 2	Course 1	Course 4	Course 3
Course 3	Course 1	Course 4	Course 3
Course 4	Course 1	Course 4	Course 3
Course 5	Course 1	Course 4	Course 3

Certification of Truth Statement
Important! Read the statement and sign below.

I affirm that the information I have provided on this application, including information that I have submitted or will submit to The Ohio State University in connection with the admission and financial aid process, is complete and accurate. I understand that submission of incomplete or inaccurate information is sufficient cause for revocation of admission or enrollment.

I authorize each academic institution I have attended to release my academic and personal information to The Ohio State University in connection with the admission and financial aid process. Pursuant to the Family Educational Rights and Privacy Act of 1974, as amended (FERPA), I hereby authorize The Ohio State University to release the information provided by me, as well as other official and unofficial Ohio State information regarding my academic progress and status, to scholarship donors for the purpose of providing the donors with information concerning my eligibility as a scholarship recipient.

Your legal name:

Today's date: (3/29/2025)