CALIFORNIA STATE UNIVERSITY SAN MARCOS
EMPLOYEE REGISTRATION FORM
WORK-RELATED COURSES
Student Name:
Social Security #:
Address:
-
Street:
Apt/Unit
City:
Telephone:
(
State:
)
Zip:
Birthdate:
Term Applying for:
Fall 20
Level of Study:
-
Spring 20
Undergraduate:
Summer 20
Graduate:
Additional information required:
Have you attended CSU San Marcos before? Yes ___ No ___; If yes, when, Semester _____ Year _____
Gender: choose M ____ (male) or F ____ (female)
Ethnic Identity (optional): Please enter a code in the box:
K Asian – Korean
S Southeast Asian (Cambodia, Laos, Thailand,
Vietnam
5 Other Asian
6 Pacific Islander
7 Caucasian, non-Hispanic
F Filipino
1 American Indian or Alaskan Native
2 African American, non-Hispanic
Mexican-American, Mexican, Chicano
Hispanic – Central America
Hispanic – South America
Other Hispanic (including Cuba, Puerto Rico,other
Caribbean Island)
C Asian – Chinese
J Asian – Japanese
3
A
B
4
8 Other
9 Decline to state
Citizenship Status: Identify your status and enter a code in the box:
Y United States Citizen
J J visa
I Immigrant
I-551 “Green Card”
R Refugee
O Other
Registration is requested for the following courses:
CRN
(e.g. 20949)
Course #
(e.g., CS 301)
Student’s Signature
6/13/2007
Section
(e.g., 01)
Units
(e.g. 3)
Instructor’s Signature
(when applicable)
Date