Non-Matriculating Student Information Form

If you plan to register for a Clark University course as a non-matriculated student, please submit the following information.
Submitting this form does not guarantee course registration.

First Name

Middle Name

Last Name

Email Address

Phone Number

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Legal Sex

Female

Male

Gender Identity

Preferred Pronouns

Citizenship

Advise which of the following apply:

I want to take a course for personal/professional enrichment

I am a Worcester Public School Teacher

I am a HFUT Summer student

I am a current Clark University Employee

I am a former Clark University Alum

Other

What is your Clark ID number?

Do you authorize us to request your transcript from the Clark University Registrar's Office on your behalf?

Non-matriculated Course Information

To confirm your course of interest is available in an upcoming term, please visit the Courses and Schedules website offered by the Clark University Registrar's Office.

Do you plan to take a graduate or undergraduate course?

What division does your course fall into?

Planned Entry Term

Which course do you plan to take during your non-matriculated semester?

Did a professor/Department invite you to take a course?

Yes

Please include the professor's name and/or Department's name

Please upload copy of a transcript from the highest level of degree completed if available. NOTE: This is not required to complete this form, but is required to confirm enrollment as a non-matriculated student. Graduate courses require completion of a bachelor's degree.

Certification

By checking this box, I certify that all information submitted within this form is true and accurate. I understand that I may be subject to admission revocation or revocation of course credit and grades should the information I certified be false.

Clark University will send you a decision letter via email to confirm your enrollment. Should you have any questions, please contact the Graduate Admissions Office at (508) 793-7373 or by email at gradadmissions@clarku.edu.