University of Pittsburgh
LAST NAME
ENROLLMENT FORM
7 digit Student ID called PEOPLE SOFT ID/PSID
FIRST NAME & M I D D L E I N I T I A L
FALL
SPRING
SUMMER
PLAN (Major)
COURSES TO BE ADDED:
5 digit Class
Number changes
every time offered
(i.e. 23456)
YEAR
PROGRAM (School)
COURSES TO BE DROPPED:
Subject
(i.e. NUR;
4 digit
Catalog Number
NURNP;
NURSP
(i.e. 2044)
Units/ *Days
credits
*Time
*Bldg/Room
Variable
Credits?
Yes or
No
Class Number
Subject
(i.e.
(i.e.
23456)
Catalog
Number
(i.e. 2028)
NUR;..)
*SUBJECT TO CHANGE – Please check your schedule in your my.pitt.edu portal >Student Center Login > Self Service for the most up-to-date information.
ALTERNATE COURSES:
TOTAL UNITS /Credits ______
The student, by signing below, herby agrees and promises to pay the University all tuition and fees resulting
from this registration.
STUDENT’S SIGNATURE
DATE
Last update 8/19/2015 ks
ADVISOR’S SIGNATURE
DATE
Units/
Credits