Special Course Application

STEP 1

Course Registration Type

Academic Program

Entry Term

Area of Interest

The following must be submitted to the Loras College Registrar's Office prior to course registration.

1. Special Course Application
2. Transcript(s):

Official high school transcript (if you are a high school student or have not attended college)
Unofficial transcript(s) from each college/university attended

Personal Information

First Name

Middle Name

Last Name

Birthdate

Email Address

Mobile Number

Social Security Number (optional)
This is stored in a secure, encrypted data field.

Sex

Female

Male

Prefer not to answer

If you wish, you may share information about your gender/gender identity here

Parent/Guardian 1 First Name

Parent/Guardian 1 Last Name

Parent/Guardian 1 Email

Parent/Guardian 1 Phone

Relationship to student

Mother

Father

Legal Guardian

Mailing Address

Country

Street

City

Region

Postal Code

Primary Citizenship

Are you Hispanic or Latino?

Regardless of your answer to the prior question, please check one or more of the following groups in which you consider yourself to be a member:

Academic Information

Please list all colleges, universities, and high schools you have attended, beginning with the most recent

Most Recent Institution

Previous Institution

Highest Degree Held

Current Employer

Enrollment Information

Please state your reasons for applying as a Special Student:

Requested Course Enrollment
PLEASE NOTE: You will only be registered for the requested courses upon your acceptance to attend Loras College as a special student.

Class Dates

Department

Course Number

Section

Course Title

Credit

Would you like to add a second course?

Yes

Class Dates

Department

Course Number

Section

Course Title

Credit

Would you like to add a third course?

Yes

Class Dates

Department

Course Number

Section

Course Title

Credit

Would you like to add a fourth course?

Yes

Class Dates

Department

Course Number

Section

Course Title

Credit

Upload Required Transcripts

STEP 2

Electronic Signature