Visiting Undergraduate Students

If you plan to register for an undergraduate course, 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

Gender

Female

Male

Citizenship

Which of the following best represents your racial or ethnic heritage? Choose all that apply.

What brings you to Clark University?

I am considering completing my bachelor's degree

I wanted to take a course for personal/professional enrichment

I am a student from another educational institution

I am a current Clark University Employee

I am a former Clark University student

I am fulfilling a course pre-requisite before matriculating at Clark University

Other

Have you earned a high school diploma?

Yes

No

What is your Clark ID number?

What courses are you interested in studying?
(Courses can be found here: https://www.clarku.edu/offices/registrar/courses-and-schedules/)

Planned Entry Term

Certification

By checking this box, I certify that all information submitted within the “Take a Single Course” 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.

We will be in touch with you soon. Should you have any questions in the meantime, please email us at spsugadmissions@clarku.edu.