High School Concurrent Program
Registration Form

NOTE: You will need a permission number from the instructor of each class to register.
Registration is on a space-available basis. There will be a limited number of face-to-face courses being offered within a specific timeframe and those classes must have space available in order for you to enroll; we cannot override enrollment limits for face-to-face classes.

You will also need e-mail approval from your high school principal or counselor, and this e-mail must be forwarded to extended@humboldt.edu. Make sure that the e-mail clearly states your full name and the course(s) that are being approved.
See the website for registration procedures.

College of Extended Education & Global Engagement
Cal Poly Humboldt • 1 Harpst St. • Arcata, CA 95521-8299
phone   707-826-3731 • e-mail   extended@humboldt.edu


Student Information

= Required field

Select your gender identity:*

Have you ever been enrolled at Cal Poly Humboldt?

Have you completed a Bachelor's Degree or higher?

Secure Information

Please supply the following information:
Humboldt ID (or Social Security Number) and Date of Birth
This information is submitted via SECURE SERVER, and is requested pursuant to Section 41201, Title 5, Calif. Code of Regulation and Section 6109 of the Internal Revenue Code.

Humboldt ID or Social Security Number (000-00-0000):required

Your date of birth is required so that Cal Poly Humboldt may identify records that are unique to you.

required

Race/Ethnicity Information

Your voluntary response is requested to comply with Federal and State legislation. If the California State University system is asked to report only ONE summary race/ethnicity description for you, choose the ONE category below that you want us to report:

 
Courses

Enter the information for the course you want to take. Include the permission number from the instructor for each course, if applicable. Also be sure to enter the fee for each course, or your registration cannot be processed.

Course 1
$
Course 2
$
Course 3
$
Enter another course

$

$
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