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Forms Manager
Data Collection Form-CE
Term
Fall 2022
Spring 2023
Fall 2023
Spring 2024
Fall 2024
Spring 2025
Fall 2025
Spring 2026
Fall 2026
Spring 2027
Last Name, First Name, Middle
Former Name (if applicable)
Banner ID
SSN
Home Address:
Address 1
Address 2
City, state & zip
Minnesota County of residence (if you are a resident of MN)
Citizenship
USA citizen
Other
Country of Citizenship if you checked OTHER above
Phone numbers:
Home phone
Cell Phone:
Work Phone:
Email Address:
Gender
Male
Female
Marital Status
Married
Single
Date of Birth (MMDDYYYY)
Ethnic (we are required to request this information by Federal Statute)
White Non Hispanic
Non-Resident Alien (non US Citizen)
Asian
American Indian or Alaskan Native
Black Non-Hispanic
Hispanic
Native Hawaiian/Pacific Islander
Two or More Races
Religious Denomination:
Roman Catholic
Methodist
Baptist
Lutheran
Episcopalian
Jewish
Buddhist
Hindu
Moslem
Christian - Other
Non-Christian - Other
None
Educational Goal:
Degree
General Interest
Certificate (Management or Ministry)
Degree Already Earned?:
Bachelor
Master
Doctorate
Other
None
Year & College where degree was earned
Year
College
If "other" listed above, indicate degree/certificate
Have you ever taken any classes through the university (this includes Continuing Education, Lifelong Learning, Wilmar-Extension, Newman Center Extension, Military Science, SJU Prep School Program, St. Cloud Hospital School of Nursing, or Special Diocese)
Yes
No
If yes, time of last Attendance (term & year)
Spring 2025
Fall 2024
Summer 2024
Spring 2024
Fall 2023
Summer 2023
Spring 2023
Fall 2022
Summer 2022
Spring 2022
Fall 2021
Summer 2021
Spring 2021
Fall 2020
Summer 2020
Spring 2020
Fall 2019
Summer 2019
Spring 2019
Fall 2018
Summer 2018
Spring 2018
Fall 2017
Summer 2017
Spring 2017
Fall 2016
Summer 2016
Spring 2016
Fall 2015
Summer 2015
Spring 2015
Fall 2014
Summer 2014
Spring 2014
Fall 2013
Summer 2013
Spring 2013
Fall 2012
Summer 2012
Spring 2012
Fall 2011
Spring 2011
Fall 2010
Spring 2010
Fall 2009
Summer 2009
Spring 2009
Fall 2008
Summer 2008
Spring 2008
Fall 2007
Summer 2007
Spring 2007
Fall 2006
Summer 2006
Spring 2006
Pre 2006
Courses Requested
CRN
Subject
Course#
Section#
Course Title
Credit Amt
Audit
Instructor
CRN
Subject
Course#
Section#
Course Title
Credit Amt
Audit
Instructor
CRN
Subject
Course#
Section#
Course Title
Credit Amt
Audit
Instructor
Alternate Courses to be considered if your first choice is unavailable
CRN
Subject
Course#
Section#
Course Title
Credit Amt
Audit
Instructor
CRN
Subject
Course#
Section#
Course Title
Credit Amt
Audit
Instructor
Student signature
Student signature date
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