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The Free Class Enrollment form is an essential document for individuals looking to take classes at Cornell University without incurring tuition costs. This form collects vital biographical information, such as your name, Cornell ID, and social security number, which is optional. You will also provide your contact information, including your email address and phone numbers. Importantly, the form requires you to indicate your enrollment period—whether you plan to take classes in spring, summer, fall, or winter. If you are a Cornell employee or a participant in the Employee Degree Program (EDP), that must be noted as well. Additionally, there is a section for demographic information to enhance the university's understanding of its participants. Here, you can specify your citizenship status and select any ethnicities that apply to you. When enrolling in classes, the form also prompts you to list the specific courses you wish to take and the number of credits associated with each. It outlines the responsibilities you need to acknowledge, including compliance with immunization laws if you are registering for six or more credits. For Cornell employees, there are additional requirements on the back of the form, which your supervisor and department head must complete for IRS reporting and eligibility verification. This comprehensive approach ensures that all necessary information is gathered for a smooth enrollment experience.

Free Class Enrollment Example

ENROLLMENT FORM

Print legibly in ink in block letters

Mail to: B20 Day Hall, Ithaca, NY 14853-2801

q Spring 20 ___

q Summer 20 ___

q Fall 20 ___

q Winter 20 ___

q Cornell employee

q EDP participant (Summer/Winter only)

 

 

 

 

 

 

1.Biographical Information Cornell ID number:_______________________ Social Security number (optional):_________________________________

Name:___________________________________________________________________________________________________________________________________

last name

first name

middle name

suffix (Jr., III, etc.)

Date of birth:___________________________ Sex: o Male

o Female

E-mail address:__________________________________________________________

month / day / year

 

 

 

Home address:____________________________________________________________________________________________________________________________

street

city

state / province / country

zip / postal code

Home phone:_ _____________________________________________________Cell phone:_____________________________________________________________

area code / country code

area code / country code

To expedite communication of important information (such as your NetID), may we send occasional text messages to your cell phone?* o Yes o No *If yes, depending on your phone plan, you may be charged for these messages.

for office use only

___________

state

Note: Please enter your address and emergency contact information in the student self-service center at studentessentials.cornell.edu.

Have you ever studied at Cornell? o Yes o No Your name when last registered, if different:_________________________ Last term attended:_____________

date

Do you hold a bachelor’s degree from any institution? o Yes o No If yes, from which institution?___________________________________________________

 

name

city / state / province (and country if not U.S.)

 

Are you a U.S. Armed Services veteran? o Yes o No Are you a New York State

o resident or o non-resident?

2. Demographic Information

 

 

 

Are you a o U.S. citizen or o dual U.S. citizen or o U.S. permanent resident or o other citizenship?_ ____________________________________________

list your country of residence Optional: Select one or more of the following ethnicities that best describe you: Are you Hispanic / Latino (including Spain)?* o Yes o No

oAmerican Indian or Alaska Native (including all Original Peoples of the Americas)* o Asian (including Indian subcontinent and Philippines)*

oBlack or African American (including Africa and Caribbean)* o Native Hawaiian or Other Pacific Islander (Original Peoples)*

oWhite (including Middle Eastern)* *Please specify:___________________________________________________________________________________________

 

3. Course Enrollment

 

 

Winter Session and Part-Time Study students must submit their tuition and fees in full when they turn in this form.

 

 

 

Will class(es) be on the Ithaca campus? o Yes o No

 

 

 

 

 

 

Department

Course

Class

 

Class

Class

Credit

Grade

 

_________________ (not required for summer or winter registration) ________________

 

number

section

component

number

hours

option

 

 

FILM

3250

001

 

LEC

1109

3

L Animation History & Practice Course Instructor✝✝

Registrar

✝✝✝

 

 

 

 

 

 

 

 

 

 

 

Title

 

Instructor’s signature or Dept. stamp

College registrar’s signature

 

 

(1)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title

 

Instructor’s signature or Dept. stamp✝✝

College registrar’s signature✝✝✝

(2)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title

 

Instructor’s signature or Dept. stamp✝✝

College registrar’s signature✝✝✝

(3)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title

 

Instructor’s signature or Dept. stamp✝✝

College registrar’s signature✝✝✝

(4)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Title

 

Instructor’s signature or Dept. stamp✝✝

College registrar’s signature✝✝✝

 

 

 

 

 

 

 

 

 

Grade options: L = letter grade; S = satisfactory/unsatisfactory; V = audit

 

Image release (please check one):

 

 

 

✝ ✝

The College of Arts and Sciences requires only the department’s stamp.

 

q I grant permission q I withhold permission

 

 

 

 

 

All other colleges require either the instructor’s or the registrar’s signature.

 

for Cornell University to use my likeness, image, and/or voice in

 

 

✝ ✝ ✝

Required only for courses in

 

 

 

 

promotional, informational, or other materials.

 

 

 

 

 

 

 

By my signature I recognize my responsibility to read, understand,

 

 

• the Johnson Graduate School of Management (106 Sage Hall),

 

 

 

• the Law School (162 Myron Taylor Hall),

 

 

 

and abide by the rules and procedures at sce.cornell.edu/scepolicies

 

 

• the School of Industrial and Labor Relations (101 Ives West).

 

and on the Cornell University Policy Office website. I further agree

 

 

 

 

 

 

 

 

 

 

 

to be bound by, and recognize that I will not be exempted from, the

 

 

 

 

 

 

 

 

 

 

 

requirements of those rules and procedures because of ignorance,

 

New York State law requires on-campus registrants taking six or more credits

 

negligence, illness, other personal factors, or contradictory advice

 

to meet immunization laws. For details see sce.cornell.edu or e-mail

 

from any source.

 

 

 

 

immunization@cornell.edu. In addition, every non-matriculated Cornell

 

 

 

 

 

 

student must complete a Health History Form, available through the “Health”

 

 

 

 

 

 

page on the Summer Session, Winter Session, and Part-Time Study websites.

 

Signature

Date

 

 

 

 

 

 

 

 

___________

ck#

___________

amt

___________

date

___________

init

oHF

4. Cornell Employees

Cornell employees must also complete and submit the back of this form.

0317

For Cornell Employees Only

Please have this section completed by your supervisor and department head.

College or division:_ ___________________________________________________________________________________________________________

Employee’s job title: ______________________________________ Employee’s work phone:_ ______________________________________________

qStatutory employee

qEndowed employee

qRegular full-time employee

qRegular part-time employee

qEmployee on layoff*

qRetired employee*

The following information is requested for IRS reporting purposes only. (Enrollment in courses through the School of Continuing Education and Summer Sessions may have tax implications. Staff members should consult with the University Human Resource Services or their tax advisor.)

qThis course serves to maintain or improve current job skills.

qThis course does not serve to maintain or improve current job skills.

*If you are on layoff or retired: You do not need to obtain supervisors’, department heads’, or Benefit Service representatives’ signatures below as the Continuing Education office will obtain these for you.

Supervisor’s signature: _____________________________________________________________________ Date: _____________________________

Department head’s signature: _ ______________________________________________________________ Date: _____________________________

The following procedures, rules, and regulations apply to full- or part-time Cornell employees or temporary Cornell employees who are eligible for benefits. Employees are also responsible for reading and abiding by the rules and regulations on the School of Continuing Education and Summer Sessions website at sce.cornell.edu.

Eligibility

Regular full- or part-time non-academic and non-professorial academic (do not have faculty voting status) Cornell employees or temporary Cornell employees who are eligible for benefits may enroll in courses for credit or audit on a space-available basis, with the permission of their supervisor and department head. Supervisors have the authority to refuse to grant permission for the employee to take courses when job responsibilities require full-time attendance during regular working hours. Employees are eligible to take only those courses that are offered for credit, excluding most special programs. Questions about eligibility should be directed to Benefit Services at 607.255.3936 or e-mail benefits@cornell.edu.

Employees who register for six or more credits must meet the New York State immunization requirements (see parttimestudy.cornell.edu).

Tuition and Course Fees

Waived Tuition: If eligible, a regular full- or part-time employee or temporary Cornell employee may take up to four credits per semester of University course offerings without charge for tuition as long as s/he remains in good standing as an employee. A new employee must have started working before the beginning of an academic term or session to be eligible for waived tuition in a course taken during that period. Tuition may not be waived if an employee drops a course without notifying the School of Continuing Education and Summer Sessions by the first day of class.

Full Tuition: Employees must pay full tuition for coursework in excess of four credits per semester. Also, a person who terminates employment while taking a course for which tuition has been waived must either withdraw from the course within the time limits stated on the School of Continuing Education and Summer Sessions website or pay the full tuition charge. An exception to this provision may be granted if less than 25% of the instruction period remains at the time of termination.

Course Fees: All employees will be billed and must pay for course fees.

Making Up Time

Supervisors may either grant employees release time for time missed from work to attend class, or require that all time be made up when the absence from work interferes with the department’s operational requirements. In cases where the supervisor has requested that a course be taken, employees are not required to make up the time. Part-time employees are expected to take courses outside of regular working hours. Employees must make up all time off for coursework in excess of four credits per semester. All assigned homework must be done on the employee’s own time.

Dropping Courses and Withdrawal

Dropping a An employee who decides to drop or add courses must comply with the regulations indicated on the School of Continuing

Course: Education and Summer Sessions website at sce.cornell.edu.

Course An employee who decides not to take any courses for which she or he has registered must immediately complete a

Withdrawal: Change-in-Enrollment form and return it to the Continuing Education office in B20 Day Hall. An employee who fails to do so will receive an “F” grade and will be liable for tuition.

Form Characteristics

Fact Name Details
Enrollment Process The form must be printed legibly in ink and mailed to B20 Day Hall, Ithaca, NY 14853-2801.
Eligibility Individuals may qualify for enrollment based on their status as Cornell employees or EDP participants, especially during the Summer or Winter sessions.
Biographical Information Applicants are required to provide their Cornell ID number, social security number (optional), name, date of birth, and contact information.
Demographic Disclosure While optional, the form encourages applicants to disclose their citizenship status and ethnicity for demographic purposes.
Tuition Requirements Winter Session and Part-Time Study students must submit full tuition and fees upon submission of the form.
Employee Benefits Cornell employees eligible for benefits can enroll in courses for credit or audit with permission from their supervisor.
Immunization Compliance New York State law mandates that registrants taking six or more credits comply with immunization laws.
Withdrawal Procedures If an employee decides not to attend courses for which they registered, they must fill out a Change-in-Enrollment form to avoid failing grades.

Guidelines on Utilizing Free Class Enrollment

Completing the Free Class Enrollment form is a straightforward process that sets the stage for your educational journey. Make sure to gather all the necessary information before you start. This will help you fill out the form accurately and efficiently, ensuring a smooth enrollment experience.

  1. Print the form legibly in ink, using block letters.
  2. Indicate the term for which you are enrolling (Spring, Summer, Fall, or Winter) by checking the appropriate box.
  3. If applicable, check the box for "Cornell employee" or "EDP participant" (for Summer/Winter only).
  4. Complete the biographical information section. Provide your Cornell ID number, name (last, first, middle), date of birth, and sex. Fill in your email address and home address, including street, city, state, and zip code.
  5. List your home phone and cell phone numbers, ensuring to include the area code.
  6. Answer the question regarding text messages. If you choose "Yes," be aware of possible charges based on your phone plan.
  7. Indicate whether you have previously studied at Cornell and, if different, provide your last registered name. Fill in the last term you attended and whether you hold a bachelor’s degree.
  8. Answer the veteran status question and indicate if you are a New York State resident or non-resident.
  9. Fill out the demographic information, including your citizenship status and any ethnicities you may wish to specify.
  10. If you are enrolling in Winter Session or Part-Time Study, prepare to submit any required tuition and fees along with your enrollment form.
  11. List the course details. Include department, course number, section, class component, credit hours, and grade option:
  12. Affix the required instructor's signature or department stamp, if applicable, and make sure to select your image release preference.
  13. Sign and date the form to affirm your understanding of the policies and requirements.
  14. If you are a Cornell employee, make sure your supervisor and department head complete the additional section on the back of the form.
  15. Mail your completed form to B20 Day Hall, Ithaca, NY 14853-2801.

After submitting your form, you will receive communication regarding your enrollment status and any further steps needed along the process. Keep an eye out for updates, as they will help you prepare for your classes effectively.

What You Should Know About This Form

1. What is the purpose of the Free Class Enrollment form?

The Free Class Enrollment form is designed for individuals interested in registering for classes at Cornell University without incurring tuition fees. This form serves both students and Cornell employees who qualify for educational benefits. By filling out the form accurately, you ensure proper enrollment and adherence to university policies.

2. How should I fill out the form if I am a Cornell employee?

If you are a Cornell employee, you must complete both the front and back sections of the Free Class Enrollment form. On the back, your supervisor and department head must provide their signatures confirming your eligibility to enroll in the selected courses. Specific details regarding your job title and work phone must be included as well.

3. Are there any fees associated with enrolling in classes?

While eligible Cornell employees can take up to four credits per semester without paying tuition, there may still be course fees that need to be paid. It is essential to review the fees associated with the specific courses you intend to enroll in. Be aware that dropping a course without notifying the university may result in full tuition charges.

4. What information is required on the Free Class Enrollment form?

The form requires various information, including your Cornell ID number, personal contact details, demographic information, and course enrollment details. Accurate completion of each section is crucial for ensuring prompt processing of your application and successful enrollment in your chosen classes.

5. Can I enroll in more than one course?

Yes, you can enroll in multiple courses. However, if you enroll in six or more credits, you must meet specific New York State immunization requirements. Additionally, Cornell employees should also remain mindful of their work responsibilities and obtain necessary permissions from their supervisors.

6. What if I need to withdraw from a course after enrolling?

If you decide not to take any courses you have registered for, you must complete a Withdrawal: Change-in-Enrollment form. This form must be returned to the Continuing Education office immediately to avoid receiving an “F” grade and being liable for tuition fees. Always keep a record of the date you submitted your withdrawal to ensure compliance with university policies.

7. How does the university use my personal information provided in the form?

Your personal information, including your likeness and contact details, may be used by Cornell University for promotional and informational purposes. If you wish to withhold permission for the use of your image, you can indicate this on the form. Understand that by providing your information, you agree to the university’s guidelines regarding its use.

Common mistakes

Filling out the Free Class Enrollment form is an important step for prospective students, yet many individuals make common mistakes that can hinder their application process. One frequent error is failing to provide clear and legible information. Whether using ink or digital formats, it is crucial to print clearly. Illegible handwriting can lead to misunderstandings, such as incorrect contact details or names, ultimately impacting communication and enrollment.

Another common oversight involves the omission of required personal details. Many people neglect to fill in crucial biographical information, such as the Cornell ID number or date of birth. Additionally, applicants sometimes leave out their emergency contact information, which can be critical for the university's records. Being meticulous in providing all requested information helps ensure a smooth enrollment process.

Not selecting the correct session can lead to complications as well. Applicants often forget to check the appropriate box for the term they wish to enroll in—spring, summer, fall, or winter. This mistake can result in processing delays and possibly affect your access to classes. Always double-check that you've identified the correct semester before submitting your form.

Another frequent blunder is neglecting to answer the demographic questions. While some sections are optional, providing this information can enhance the university’s efforts towards diversity and inclusion. Moreover, failing to respond may delay the processing of the form, which can be frustrating for those eager to start classes.

Additionally, some applicants mistakenly skip the section regarding previous attendance at Cornell. This section is essential for the university to evaluate your enrollment history properly. Therefore, failing to specify whether you have previously studied there can lead to unnecessary confusion and delays.

Lastly, it’s essential to remember to sign and date the form before submitting it. A signature confirms the information provided is accurate and that you understand the university’s policies. Without this important step, your application may be deemed incomplete and returned for signatures, thereby prolonging your enrollment process.

Documents used along the form

The process of enrolling in classes at Cornell involves various forms beyond the Free Class Enrollment form. Each of these documents plays a crucial role in ensuring that students have met specific requirements and that their personal information is accurately recorded. Below are some commonly used forms that might accompany the enrollment process.

  • Health History Form: Required for non-matriculated students, this form collects important health information. It helps ensure that the university can accommodate any medical needs and comply with immunization laws.
  • Credit Transfer Form: If a student wishes to transfer credits from another institution, this form is necessary. It allows the university to evaluate the credits and update the student’s academic record accordingly.
  • Change-in-Enrollment Form: This form is used when students need to add or drop courses after the enrollment period. Timely completion of this document is essential to avoid academic penalties.
  • Emergency Contact Form: This form is crucial for students to provide information about whom to contact in case of an emergency. It is part of maintaining student safety and well-being on campus.
  • Financial Aid Application: For students seeking financial assistance, completing this application is vital. It helps the university assess needs and determine eligibility for various aid programs.
  • Student Self-Service Information Update: This is a digital platform where students must enter their personal details, such as their home address and emergency contact information. Keeping this info current is essential for timely communication from the university.

These forms and documents work together to facilitate a smooth enrollment experience. Ensuring that each is correctly completed and submitted can help students focus on their academic goals without unnecessary delays or complications.

Similar forms

  • Application Form: Like the Free Class Enrollment form, the application form collects personal information and details to assess eligibility for a specific program or service. Both require identification, including name, contact information, and sometimes social security numbers.
  • Registration Form: This document is similar in purpose as it captures details necessary for participating in courses or events. It often includes demographic information, course selections, and agreement to terms, much like the enrollment form.
  • Health History Form: Required for educational institutions, this form gathers health-related information and requires the individual's signature. Both forms involve personal information and may have implications for participation in programs.
  • Student Information Form: It serves to compile students' essential information for administrative purposes, mirroring the structure of the Free Class Enrollment form in terms of personal data collection, such as previous education and contact details.
  • Tuition Waiver Application: This form is related to the Free Class Enrollment form because it determines eligibility for financial benefits. Both necessitate employment status and details about the courses for which individuals are seeking enrollment or benefits.
  • Consent Form: Similar to the image release section in the enrollment form, consent forms are often required in educational settings. They gather permission for specific uses of the individual's information or likeness, reinforcing the idea of informed consent across various contexts.

Dos and Don'ts

When filling out the Free Class Enrollment form, it's essential to follow some guidelines to ensure a smooth process. Below is a list of things you should and shouldn't do:

  • Do: Print legibly in ink using block letters.
  • Do: Provide accurate personal information, including your Cornell ID number and date of birth.
  • Do: Indicate your preferred academic term clearly, whether it’s Spring, Summer, Fall, or Winter.
  • Do: Confirm if the class will be held on the Ithaca campus and note any prerequisite information.
  • Do: Check your eligibility for financial aid if you are a Cornell employee or EDP participant.
  • Do: Include your emergency contact information as required.
  • Do: Read all the instructions carefully to avoid any mistakes.
  • Don't: Leave any sections blank; every piece of information counts.
  • Don't: Forget to sign and date the form at the end.
  • Don't: Use pencil or any ink color other than black or blue.
  • Don't: Misrepresent yourself; provide truthful responses about your background and status.
  • Don't: Ignore instructions regarding your health history, especially if you’re a non-matriculated student.
  • Don't: Submit the form without confirming that all the information is complete and correct.
  • Don't: Rely solely on verbal communication for course approvals; and ensure you have written confirmation if needed.

Misconceptions

Understanding the Free Class Enrollment form can save you time and prevent misunderstandings. Here are seven common misconceptions about the form, along with explanations to clarify them:

  • This form is only for current students. In reality, the Free Class Enrollment form is open to Cornell employees and EDP participants as well. Past students may also enroll for classes.
  • My Social Security number is mandatory. The form states that providing your Social Security number is optional. You can leave this blank if you prefer.
  • All classes must be taken on campus. While many courses are campus-based, the form allows for distance learning options. Always check the course details for availability.
  • I must pay tuition in advance for all courses. Only students in Winter Session and Part-Time Study programs need to submit tuition and fees with the enrollment form. Other sessions may have different requirements.
  • My supervisor has to approve my enrollment every time. This applies only to employees taking courses during working hours. If you’re enrolled outside working hours, you do not need supervisor approval.
  • I can't change my registration once it's submitted. You can drop or add courses, but you must follow the procedures outlined on the School of Continuing Education and Summer Sessions website.
  • I don't need to worry about immunization if I'm only taking one course. If you're registering for six or more credits, immunization requirements do apply, regardless of whether you're a full-time student or a non-matriculated student.

Be sure to read all instructions on the form carefully. Understanding the rules will help make your enrollment process smoother and more efficient.

Key takeaways

When completing the Free Class Enrollment form, consider the following key points:

  • Accuracy is Essential: Fill in the form with clear, legible handwriting. Ensure that all personal details, including your name and Cornell ID number, are correct to avoid delays in processing.
  • Tuition Requirements: Be aware that Winter Session and Part-Time Study students must pay their tuition and fees in full at the time of submission, which ensures your spot in the chosen class.
  • Emergency Contact Information: While filling out the form, remember to enter your address and emergency contact details in the student self-service center. This is a requirement for all students.
  • Signature for Confirmation: Your signature on the form indicates that you understand the responsibilities outlined by Cornell University regarding course registration, including attendance and immunization requirements.
  • Employee Considerations: If you're a Cornell employee, complete the back section of the form. Be informed about your eligibility for waived tuition and any potential tax implications related to course enrollment.

Pay close attention to these aspects while engaging with the enrollment process. They will help facilitate a smoother experience as you begin your classes.