Be Boulder Anywhere
1111 Engineering Dr., ECOT 126
435 UCB
Boulder, CO 80309-0435
T: 303-492-6331
F: 303-492-5987
BeBoulderAnywhere@colorado.edu
beboulderanywhere.colorado.edu
Refer to the campus Academic Calendar for important deadline dates. After the enrollment deadline a late fee may apply.
Term: Fall Spring Summer Year
Student Status : Admitted Degree-Seeking: Non-Degree:
Student Information
Last Name: First Name:
CU Student # or Social Security #: Phone #:
Middle Name:
E-mail:
Maiden Name:
Courses Desired
Check the Be Boulder Anywhere Course Schedule for availability. Enrollment for in-class students begins the Friday before classes start.
1
Type of Class Dept & Course #
Distance
In-Class
Library
Credit
Hrs
Credit/ No
Credit/Pass or
Fail
Credit
No Credit
Pass/Fail
Course Title Instructor
2
Distance
In-Class
Library
Credit
No Credit
Pass/Fail
Exam/Quiz Proctor Information (you must check a box)
Most distance courses require an appropriate person to proctor your exams/quizzes (EMEN courses do not require proctors). The proctor may be a supervisor/manager, education/training or personnel official, or a librarian. The proctor may NOT be a friend, relative, or subordinate.
Does your course require a proctor? (If you do not know, contact the instructor.)
No Proctor/Not Applicable: Course does not require exams/quizzes to be proctored.
No Proctor: I will take exams in the classroom on the Boulder campus
Yes, Proctor is required, but to be arranged (TBA)
Yes, Proctor is required, and the information is below.
Proctor Name Company Proctor Relationship to you
Proctor Mail Address (no, st, apt)
(state) (zip)
Proctor E-mail
(mail stop)
Proctor Country
Phone ( _____ )
(city)
Fax ( _____ )
Tuition and Fee Agreement and Disclosure
I hereby acknowledge that I have read and expressly consent to the University’s Tuition and Fee Agreement and Disclosure . By checking the box, I agree that I have carefully read the disclosure, fully understand it, and agree to be legally bound by it.
Registrant’s Signature ______________________________________________________ Date
Instructor/Department Approval (required for students taking Library, thesis, or capstone courses. Instructor sign below or attach instructor email or other written document)
_____________________________________________________________________
Print Name & Sign
Date _______________
Be Boulder Anywhere is the campus-wide delivery platform for distance education
11/30/15