Please fill out this form completely. You can submit the form on line, or print it out and mail it to the PSR Registrar at 1798 Scenic Avenue, Berkeley, CA 94709. For more information, contact the PSR Registrar at 510/849-8252.
Last Name
First Name
E-Mail Address
Street Address
City
State
Postal Code
Country
Day Phone
Evening Phone
Term in which you wish to take classes
Fall January Intersession Spring Summer - only applicants who qualify for a "special rate" (check off at least one of questions 1-7 below) should submit this application for Summer. All others should enroll for CEU's through www.psr.edu/summer at a lower rate.
Year in which you wish to take classes
For what purposes do you wish to take courses?
What is your primary area of interest?
List the first class you would like to take. (Look up course from GTU Master Course Schedule )
Do you wish to take this course for audit or for credit?
Audit (sit in course for no credit) Credit (letter or pass/fail grade issued for academic credit. Note that only applicants who qualify for a special rate by checking at least one of the questions (1-6) below may use this application to enroll for credit. All others interested in enrolling for credit should complete the Special Student application instead.)
List the second (if applicable) class you would like to take. (Look up course from GTU Master Course Schedule )
Do you wish to take this course for audit or for credit?
Audit (sit in course for no credit) Credit (letter or pass/fail grade issued for academic credit. Note that only applicants who qualify for a special rate by checking at least one of the questions (1-6) below may use this application to enroll for credit. All others interested in enrolling for credit should complete the Special Student application instead.)
Special Discount Category Questions #1-7
1. Are you a graduate of PSR?
Yes
1a. If yes, degree and year of graduation
2. Have been you a Field Education Mentor/Supervisor within the past 5 years? If yes, please have the Field Education Director email the PSR registrar verification of your Mentor/Supervisor status.
Yes No
3. Have you been a PSR Adjunct Faculty within the past 5 years?
Yes No
4. Are you a PSR Staff or Faculty Emeriti?
Yes No
5. Are you a special guest of PSR? If so, please forward the email approval of the Dean to the PSR Registrar.
Yes No
6. Are you a regular employee (non-student worker) of PSR during the term you wish to take courses?
Yes No
6a. If yes, enter your title and department, and please have your supervisor send the PSR registrar their approval:
7. Are you a spouse of a PSR student (enrolled full time) during the term you wish to audit?
Yes No
7a. If yes, name of your spouse & number of units spouse is registered for.
Please list, in chronological order, your previous higher education
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