Non-Degree Student Application

Submit this form on the web to be considered for taking Columbia courses under non-matriculated status.

Section I -- General Information
( *   denotes required fields)
 
* Last Name:   * First Name: Middle Initial:  
* Street Address(Home):  
* City:   * Postal Code:  
* State/Province:  
* Country:  
* Company Name:   (If not applicable, enter "None".) Dept:
Building/Mail Code and ROOM NUMBER:  
Street Address(Company):  
City:   Postal Code:  
State/Province:  
 
  Phone number format must be ### - ### - ####
Please enter 'None" if you have international phone, work, or fax numbers and e-mail registration@cvn.columbia.edu your contact numbers.
* Home Phone:   * Work Phone: Ext:  
Fax:  
* Email address:   (required)
Alternate email address:
* Gender:
 
* Country of Citizenship:
 Ethnicity (optional):
 
Please double check to make sure all information is complete and correct.

Section II -- Academic Background

Academic Background - List all institutions attended, beginning with most recent:
College/University Major Field of Study GPA Degree Date Received
*